Claims Examiner - Remote, NE

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Customer Service

Full-time

Class starting on September 28th, to work remotely in Nebraska!

At Ameritas, our mission is Fulfilling Life. We do that in many ways, but especially by helping people invest in themselves by offering trusted financial products and advice. Because we believe everyone should be happy, healthy and financially secure, we work hard to provide trusted financial products and valued guidance, including individual life and disability insurance, employee benefits, retirement planning, investments, and wealth management services.

• This position is remote (within Nebraska) and does not require regular in-office presence.

The Claims Examiner processes dental claims by using claims knowledge in accordance with the specific policy and/or processing guidelines. This position provides service to customers by communicating with providers and insureds to professionally evaluate claims or answer general inquiries under limited supervision.

What you do:

• Review and provide resolution for claims rejected by the auto-adjudication process in accordance with the departmental accuracy and responsiveness standards using the claims/image system and various sub-systems.
• Recognize procedure codes, tooth numbers, etc. and understand how they interrelate to ensure claims for all products were processed appropriately. (Functions will include claims processes for all products - dental, vision and hearing products.)
• Resolve inquiries and problems and arrive at a quick, accurate and satisfactory resolution. Manually process claim re-submissions.
• Knowledge of various contracts and marketing arrangements including PPO contracts and service guarantees. Interpretation of coordination of benefits and other policy provisions, company practices and transition guidelines.
• Apply policy provisions and knowledge of company philosophy to ensure compliance with the contract, legal requirements and guidelines established by various states' regulations.
• Provide second review of claims.
• Work the front desk, either as primary, back-up, or as part of a rotation with other associates.
• Ability to work periods of overtime as required based upon business need.
• Other duties as assigned

What you bring:

• H.S. Diploma or GED required
• 0-2 years related experience required
• Experience in a dental related field or claim processing environment helpful.
• Must possess problem solving and analytical skills.
• Organizational and time management skills
• Must possess good grammar in speaking and writing; should have good verbal skills in formal and informal business settings and be able to write clearly.
• Proficient use of personal computer system and keyboarding skills.
• Ability to quickly adapt to new procedures and job functions derived from changes in laws and business relationships.

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.

Application Deadline
This position will be open for a minimum of 3 business days or until filled.

This position is not open to individuals who are temporarily authorized to work in the U.S.

The pay range posted reflects a nationwide minimum to maximum covering all potential locations where the position may be filled. The final determination on pay for any position will be based on multiple factors including role, career level, work location, skill set, and candidate level of experience to ensure pay equity within the organization. This position will be eligible to participate in our comprehensive benefits package (see above for details). This position will be eligible to participate in our Short-Term Incentive Plan with the annual target defined by the plan.

Pay Range Pay Range

The estimated pay range for this job. Disclosing pay information promotes competitive and equitable pay.

The actual pay rate will depend on the person's qualifications and experience.

$16.28 - $26.05 / hour

Pay transparency is rooted in principles of fairness, equity, and accountability within the workplace. Sharing pay ranges for job postings is one way Ameritas shows our commitment to equitable compensation practices.