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Claims Auditor

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Robert Half

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Location:
United States , Omaha

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Category:
Finance

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Contract Type:
Employment contract

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Salary:

Not provided
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Job Description:

We are looking for a detail-oriented Claims Auditor to join a Financial Services organization in Omaha, Nebraska. In this role, you will evaluate benefit and insurance claim submissions, apply policy provisions accurately, and help ensure timely, well-documented payment decisions. This position is ideal for someone who combines analytical judgment, strong written communication, and a commitment to handling sensitive information with care.

Job Responsibility:

  • Examine claim forms, supporting records, and benefit requests to determine coverage eligibility and decide whether claims should be approved, declined, or held pending additional documentation
  • Record claim activity, decisions, and supporting details in the claims administration system with a high degree of accuracy and completeness
  • Prepare written communication to claimants, beneficiaries, financial institutions, medical providers, attorneys, and internal partners to explain outcomes or request missing information
  • Assess medical documentation, application details, and policy exclusions to confirm whether coverage requirements were satisfied at issue and escalate questionable disclosures for legal review when appropriate
  • Validate beneficiary information on life claims to confirm that proceeds are directed to the correct eligible party
  • Review applicable state regulations during life claim processing, including required beneficiary verification checks related to child support compliance
  • Recognize indicators of suspicious activity, document concerns thoroughly, and refer potential fraud matters to the appropriate legal team
  • Respond to questions from sales partners, account contacts, and internal teams regarding claim status, benefit determinations, and related service issues
  • Monitor open items and follow through on pending claims to obtain outstanding records and keep cases moving toward resolution
  • Support departmental workflow by assisting with cross-coverage, special assignments, and collaboration across teams to resolve issues efficiently

Requirements:

  • Associate degree in Business or a related field, or an equivalent combination of education and relevant experience
  • At least five years of experience in claims auditing or claims review with increasing responsibility
  • Practical background in resolving customer or client service issues in a detail-oriented setting
  • Strong computer proficiency, including the ability to navigate multiple software applications and maintain accurate electronic records
  • Working knowledge of claims processing, claims data review, and insurance claim evaluation
  • Ability to safeguard confidential and sensitive information with discretion

Nice to have:

  • Insurance coursework or industry designations are preferred
  • Previous exposure to credit insurance, life claims, or medical terminology is beneficial
What we offer:
  • Medical, vision, dental, and life and disability insurance
  • Company 401(k) plan
  • Free online training
  • Access to top jobs
  • Competitive compensation and benefits

Additional Information:

Job Posted:
May 16, 2026

Employment Type:
Fulltime
Work Type:
On-site work
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