Claims Adjudicator II — On-Site + Flexible Remote Days

Paycom; Elkhorn Precinct (NE); Hybrid; USD 36,000 - 40,000; Full time

Benefits offered by this job

Medical

Health Savings Account

Dental

Vision

Dependent Care FSA

Gym access

Life Insurance

Disability

Paid Holidays

PTO

401(k)

Job summary

Guarantee Trust Life in the Omaha-area (Elkhorn, NE) office is seeking a Medical Claims Adjuster to adjudicate claims based on contract provisions and state guidelines. The role requires strong knowledge of policy language, medical terminology, and benefit administration.

You will work on-site most days with three flexible remote days per month and enjoy half-day Fridays. Candidates should have 2–3 years of claims experience, solid data entry skills, and excellent communication.

Qualifications

• 2–3 years of medical health claim adjusting experience, preferably hospital indemnity claims.
• Experience reading and referencing policy language for benefit administration.
• Experience in preexisting or investigations a plus.
• Basic knowledge of Microsoft Office Word and Excel.
• Strong data entry skills.
• Excellent verbal and written communication.
• Ability to analyze risk.
• Must have good judgment and strong prioritizing and organizational skills.

Responsibilities

• Adjudicate medical claims based on contract provisions and benefits according to state guidelines.
• Understand policy contract language, insurance applications, and medical terminology.
• Collaborate with departments to ensure accurate claim resolution.

Skills

Medical claim adjusting

Policy language interpretation

MS Word & Excel

Data entry

Communication skills

Risk analysis

Judgment & prioritization

Tools

Microsoft Office

Job description

Guarantee Trust Life in the Omaha-area (Elkhorn, NE) office is seeking a Medical Claims Adjuster to adjudicate claims based on contract provisions and state guidelines. The role requires strong knowledge of policy language, medical terminology, and benefit administration.

You will work on-site most days with three flexible remote days per month and enjoy half-day Fridays. Candidates should have 2–3 years of claims experience, solid data entry skills, and excellent communication.