Claims Examiner (Remote)

300 American Income Life Insurance Company; Texas; Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Paid holidays

Education reimbursement

Job summary

American Income Life Insurance Company is seeking a Claims Examiner to join our team in a remote/work-from-home role. You will evaluate claims for eligibility, investigate, calculate benefits, and process claims according to policy contracts and company procedures.

You will serve as a primary contact for policyholders, agents, and medical providers, using your 50 wpm typing, medical terminology knowledge, and MS Office skills to ensure accurate, timely processing in a fast-paced environment.

Qualifications

• Bachelor's degree or 1–2 years of related experience.
• Six months' experience in a Claims Department Data Entry & Mail Distribution Representative (LG4) or four years in a non-entry level role.
• Minimum typing speed of 50 wpm.
• Knowledge of medical coding and terminology; 98%+ on Medical Terminology exam.
• Advanced proficiency in Outlook, Excel, Word.
• Strong organizational skills and attention to detail.
• Excellent written and verbal communication.
• Ability to thrive in a fast-paced environment with limited supervision.
• Knowledge of the insurance industry and claims handling preferred.

Responsibilities

• Evaluate claims to determine eligibility for benefits per policy contracts.
• Process claims according to procedures and perform necessary accounting entries.
• Exercise independent action and judgment in claims decisions.
• Communicate with policyholders, representatives, claimants, agents, and medical providers via phone, email, and written correspondence.
• Perform duties with a high degree of accuracy.
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Skills

Typing 50 wpm

Medical terminology

MS Office proficiency

Communication skills

Attention to detail

Independent work

Insurance industry knowledge

Education

Bachelor's degree or equivalent experience

High school diploma or equivalent

Tools

Medical coding systems

Data entry systems

Job description

At American Income Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to Make Tomorrow Better.

Role Overview

Could you be our next Claims Examiner? American Income Life is looking for a Claims Examiner to join the team! This role is responsible for the evaluation, investigation, benefit calculation, and processing of claims within the guidelines of policy contracts and Company procedures. The Claims Examiner plays a key role in ensuring accurate and timely claims processing while serving as a point of contact for policyholders, agents, and medical providers. This is a remote / work-from-home position.

What You Will Do

• Evaluate claims to determine eligibility for benefits in accordance with policy contracts.
• Process claims according to Company procedures and perform necessary accounting entries to complete claims processing.
• Exercise independent action and judgment in claims decisions.
• Communicate directly with policyholders, PR Representatives, Marketing Specialists, claimants, agents, and/or medical providers via telephone, e-mail, and written correspondence.
• Perform all duties with a high degree of accuracy.
• Other duties as required by the department.

What You Can Bring

• Bachelor's degree from a four-year college or university, or 1–2 years of related experience and/or training; or equivalent combination of education and experience.
• Six months' experience in a Claims Department Data Entry & Mail Distribution Representative position (LG4), or four years in a non-entry level position (LG4 or higher).
• Minimum typing requirement of 50 wpm.
• High School diploma or equivalent.
• Knowledge of medical coding and terminology; must score 98% or better on the Medical Terminology exam.
• Proficiency in Microsoft Office Suite (Outlook, Excel, Word) at an advanced level.
• Skilled in performing intermediate arithmetic calculations.
• Strong organizational skills and detail-oriented approach to work.
• Excellent written and verbal communication skills.
• Ability to thrive in a fast-paced environment while working independently and with limited supervision.
• Positive, team-oriented attitude with flexibility to adjust to changes as they arise.
• High technical aptitude with the ability to learn new systems quickly.
• Knowledge of the insurance industry and claims handling experience preferred.

Promotion Opportunity

• This position is eligible for the Claims Examiner II (LG8) position upon meeting the following criteria:
• One year of experience in the Claims Examiner position (LG7) and successful completion of ICA Medical Aspects of Claims and ICA Life and Health Insurance Law (or successor courses) - OR - five years of experience in the Claims Examiner position (LG7).
• Score 98% or better on the Medical Terminology exam.
• Demonstrate fully competent performance for two quarters preceding advancement in all functions performed in the Claims Examiner position (LG7).

How American Income Life Will Support You

• Competitive compensation designed to reflect your expertise and contribution.
• Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance.
• Robust life insurance benefits and retirement plans, including a pension plan.
• Paid holidays and time off to support a healthy work-life balance.
• Parental leave to help our employees welcome their new additions.
• Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.
• Company-paid counseling for assistance with mental health, stress management, and work-life balance.
• Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career.
• Discounted Texas Rangers tickets for a proud visit to Globe Life Field.

Terms and Conditions

Want an exciting opportunity in the insurance industry? Some insurance companies only care about making money from their insurance policies. But at American Income Life, we care about people. And Agents who choose to sell our products have an opportunity to make an impact on their clients, their community, their family, and their career. There’s way more to it than meets the eye. American Income Life attracts a select group of leaders, entrepreneurs, and high achievers eager to jumpstart their sales career with a fast-paced, stable, and internationally growing company.

Opportunity Unlimited

At American Income Life, 'Opportunity Unlimited' means you decide what you are worth. As an independent contractor, you are in control. Your performance determines how much money you make and how far you take your career. Selling American Income Life products gives you the opportunity to earn as much as you desire.