Remote Claims Auditor: Benefits & Life Claims

Central States Health & Life Co. of Omaha; Omaha (NE); Hybrid; USD 52,000 - 72,000; Full time

Job summary

CSO in Omaha, NE seeks a dedicated Claims Auditor to review and authorize payment of benefits per policy guidelines. You will evaluate claim forms, enter data, and communicate determinations to insureds, banks, and attorneys. The role requires strong written/verbal skills and attention to detail, with opportunities to assist with special projects.

Full-time, hybrid work arrangement with on-site and remote options; prior experience in life claims and compliance is preferred.

Qualifications

• Associates degree or equivalent experience required.
• 5+ years in claim auditing with progressive responsibilities.
• Excellent written and verbal communication abilities.

Responsibilities

• Review, analyze, and authorize payment of benefits within guidelines.
• Enter claims data into the claims system and document details.
• Correspond with banks, agents, lawyers, and claimants on payment determinations.
• Handle inquiries by phone or email regarding claims status and policy provisions.
• Perform claim reviews of medical information for eligibility and exclusions.
• Review life claims and beneficiary eligibility; data-match where required.
• Identify fraud indicators and refer to Legal for review.
• Support home office sales force and accounts with questions and status.
• Follow up on pending claims and stay current on state requirements.

Skills

Verbal communication

Written communication

Attention to detail

Strong organizational skills

Computer skills

Education

Associates Degree in Business or equivalent

Five years of claim auditing experience

Job description

CSO in Omaha, NE seeks a dedicated Claims Auditor to review and authorize payment of benefits per policy guidelines. You will evaluate claim forms, enter data, and communicate determinations to insureds, banks, and attorneys. The role requires strong written/verbal skills and attention to detail, with opportunities to assist with special projects.

Full-time, hybrid work arrangement with on-site and remote options; prior experience in life claims and compliance is preferred.