Sr. Life Claims Examiner

ameritasexternal; United States; Remote; USD 52,000 - 66,000; Full time

Benefits offered by this job

401(k) Retirement Plan with company m

Tuition Reimbursement and Assistance

Incentive Program Bonuses

Competitive Pay

Flexible Hybrid work

Paid time off (PTO)

Job summary

Ameritas seeks a claims adjudicator to evaluate and authorize complex claim dispositions. You will analyze medical records and financial documents, initiate medical reviews, and collaborate with Legal and Underwriting to render decisions.

The role requires a bachelor’s degree or equivalent experience and 1–3 years of related work in claims. Expect a supportive team, flexible hybrid options, and opportunities to advance within a respected financial services insurer.

Qualifications

• Bachelor’s degree or equivalent experience required.
• 1-3 years of related experience required.

Responsibilities

• Evaluates and authorizes disposition of complex claims.
• Obtains and analyzes medical records and financial documents.
• Initiates and monitors medical reviews, independent medical examinations, surveillance, and financial reviews.
• Corresponds with policyholders, attorneys, medical facilities, reinsurers, outside vendors, and insured's employer.
• Interacts and requests formal written opinions from Legal and Medical/Underwriting departments.
• Makes decisions on evaluation of claims using judgment, experience, and collaboration with senior associates.
• Assists with recoveries from reinsurance carriers.
• Performs all claims processing support functions.

Education

Bachelor’s Degree or equivalent experience

Job description

This position uses strong subject matter knowledge to evaluate, analyze, and adjudicate claims in compliance with state and federal laws while providing timely and accurate service to clients. The incumbent works independently and influences others to achieve operational targets and customer retention.

• Position Location: This position is remote in Nebraska or Ohio and does not require regular in-office presence.

What you do:

• Evaluates and authorizes disposition of complex claims.
• Obtains and analyzes medical records and financial documents.
• Initiates and monitors medical reviews, independent medical examinations, surveillance, and financial reviews.
• Corresponds with policyholders, attorneys, medical facilities, reinsurers, outside vendors, and insured's employer.
• Interacts and requests formal written opinions from Legal and Medical/Underwriting departments.
• Makes decisions on evaluation of claims using judgment, experience, and collaboration with senior associates.
• Assists with recoveries from reinsurance carriers.
• Performs all claims processing support functions.

What you bring:

• Bachelor’s Degree or equivalent experience required.
• 1-3 years of related experience required.

What we offer:

A meaningful mission. Great benefits. A vibrant culture

Ameritas is an insurance, financial services and employee benefits provider Our purpose is fulfilling life. It means helping all kinds of people, at every age and stage, get more out of life.

At Ameritas, you’ll find energizing work challenges. Flexible hybrid work options. Time for family and community. But dig deeper.Benefits at Ameritas cover things you expect -- and things you don’t:

Ameritas Benefits

For your money:

• 401(k) Retirement Plan with company match and quarterly contribution
• Tuition Reimbursement and Assistance
• Incentive Program Bonuses
• Competitive Pay

For your time:

• Flexible Hybrid work
• Thrive Days - Personal time off
• Paid time off (PTO)

For your health and well-being:

• Health Benefits: Medical, Dental, Vision
• Health Savings Account (HSA) with employer contribution
• Well-being programs with financial rewards
• Employee assistance program (EAP)

For your professional growth:

• Professional development programs
• Leadership development programs
• Employee resource groups
• StrengthsFinder Program

For your community:

• Matching donations program
• Paid volunteer time– 8 hours per month

For your family:

• Generous paid maternity leave and paternity leave
• Fertility, surrogacy and adoption assistance
• Backup child, elder and pet care support

An Equal Opportunity Employer

Ameritas has a reputation as a company that cares, and because everyone should feel safe bringing their authentic, whole self to work, we’re committed to an inclusive culture and diverse workplace, enriched by our individual differences. We are an Equal Opportunity/Affirmative Action Employer that hires based on qualifications, positive attitude, and exemplary work ethic, regardless of sex, race, color, national origin, religion, age, disability, veteran status, genetic information, marital status, sexual orientation, gender identity or any other characteristic protected by law.