Claim Examiner - Medicare Supplement

Physicians Mutual Insurance Company, Inc. • Omaha, NE

2d

About The Position

Physicians Mutual is actively hiring Medicare Supplement Claims Examiners to join their growing Claims team. In this role, you will evaluate and process insurance claims by analyzing policy provisions, medical information, and supporting documentation to determine accurate payment or denial decisions. You will also communicate with policyholders, providers, and internal teams to ensure timely, professional service throughout the claims process. This is an opportunity to launch or grow a career in the health insurance industry with a company known for stability and integrity. The Physicians Mutual family, including Physicians Mutual Insurance Company, Physicians Life Insurance Company, and Physicians Select Insurance Company, empowers people to enjoy financial security. They offer dental, supplemental health, pet, life, and Medicare Supplement insurance, as well as coverage for funeral pre-planning. Established in 1902, Physicians Mutual is one of the nation’s leading health and life insurance providers, rated in the top 1% of insurance companies with high financial strength ratings and a 95% customer satisfaction rating.

Requirements

• High school diploma or equivalent
• Strong written and verbal communication skills
• Computer proficiency and comfort using internal claims processing systems
• Ability to work efficiently in a fast-paced, metrics-driven setting
• Problem-solving mindset and a keen eye for detail
• Basic math skills for benefit and interest calculations

Nice To Haves

• 1–2 years of experience in health insurance claims or a related field
• Knowledge of Medicare Supplement insurance

Responsibilities

• Review, analyze, and process claims in accordance with policy provisions, company guidelines, and state regulations
• Investigate claims by gathering and evaluating information from policyholders, providers, and internal systems
• Determine appropriate claim outcomes, including payment, denial, or further investigation
• Calculate benefits and ensure accurate and timely claim payments
• Verify claim information against policy records, prior claims, and supporting documentation
• Communicate claim decisions clearly and professionally to customers and other stakeholders
• Maintain accurate documentation and update claim records in system applications
• Stay current on policy updates, medical terminology, and regulatory requirements
• Manage workload effectively to meet productivity and quality standards

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees