Remote Claims & Benefits Analyst

Central States Health & Life Co. of Omaha; Omaha (NE); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Central States Health & Life Co. of Omaha in Omaha, NE is seeking a claim auditor to review, analyze, and authorize payment of benefits within policy guidelines.

You will evaluate forms for eligibility, determine payment actions, enter data into the claims system, and prepare correspondence with banks, lawyers, doctors, and claimants.

The role requires strong communication, attention to detail, and the ability to resolve issues with insureds and beneficiaries while staying compliant.

Qualifications

• Associates Degree in Business or equivalent experience.
• Five years of claim auditing experience.
• Customer service experience with issue resolution.
• Strong verbal and written communication; attention to detail.

Responsibilities

• Review, analyze, investigate, and authorize payment of benefits within guidelines.
• Assess claim/benefit forms for eligibility and determine payment actions.
• Enter claims data into the claim system and document information.
• Prepare correspondence to banks, agents, lawyers, providers, claimants, or beneficiaries.
• Communicate with insureds and others about status and policy provisions.
• Review life claims for valid beneficiaries and eligibility.
• Identify potential fraud and refer to Legal.
• Provide support to home office sales force and accounts with questions.

Skills

Communication skills

Customer service

Attention to detail

Organizational skills

Verbal communication

Written communication

Education

Associates Degree in Business

Tools

Office software

Claim management software

Job description

Central States Health & Life Co. of Omaha in Omaha, NE is seeking a claim auditor to review, analyze, and authorize payment of benefits within policy guidelines.

You will evaluate forms for eligibility, determine payment actions, enter data into the claims system, and prepare correspondence with banks, lawyers, doctors, and claimants.

The role requires strong communication, attention to detail, and the ability to resolve issues with insureds and beneficiaries while staying compliant.