Claims Examiner

Position Description:

Class starting on March 10th ,2025 to work remotely in Utah!

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.

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.

What we offer:

• Hiring/Retention Bonuses up to $850!
• Competitive starting wage of $18 per hour
• Annual Short-Term Incentive (Bonus) Plan

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

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

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

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

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

• 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.

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 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.