# Amera

> Claims automation platform for self\-funded health plans and TPAs

## At a glance

| Field | Value |
| --- | --- |
| Category | Claims Technology |
| Type | Solutions Provider |
| Region | NA |
| Headquarters | Seattle, Washington |
| Founded | 2025 |
| Stage | Startup |
| Employees | 1-10 |
| Funding | Seed |

## Overview

Amera is a claims processing automation platform for self-funded health plans, third-party administrators (TPAs), and plan administrators in the health insurance sector. The company targets a specific pain point: the legacy COBOL-era infrastructure that self-insured employers -- who collectively cover approximately 160 million Americans -- still rely on for claims processing, resulting in high rates of manual work and costly exception handling.

The platform standardizes claim inputs from any source format -- EDI files, PDFs, paper bills, faxes, and proprietary systems -- through a unified intake pipeline, then automates the workflow from intake through carrier submission and stop-loss reporting. The normalization engine targets 99%+ data accuracy, and the intelligent pre-processing layer automates routing and editing based on configurable business rules. Amera integrates with existing claims software, clearinghouses, and carrier portals rather than requiring a system replacement.

Founded in 2025 and part of Y Combinator's Fall 2025 cohort, Amera was already working with payers and plan administrators representing approximately 100,000 members at time of research.

## Products & services

### Claims Intake & Normalization

Converts incoming claim data from any format into standardized, actionable workflows through a unified intake pipeline. Handles EDI files, PDFs, paper bills, faxes, and proprietary system outputs.

**Key features:**

- Multi\-format ingestion \(EDI, PDF, paper, fax, proprietary\)
- 99%\+ data accuracy across all formats
- Automatic validation, error flagging, and compliance checks

*Target users:* TPAs, plan administrators, self\-insured employers

### Intelligent Claims Pre\-processing

AI-driven routing and editing layer that learns payer business rules and automates manual adjudication workflows.

**Key features:**

- 85%\+ auto\-adjudication rate
- Real\-time eligibility verification and provider validation
- Smart duplicate detection and configurable business rules engine

*Target users:* TPAs, plan administrators

### Automated Stop\-Loss Reporting

Generates and submits stop-loss reports to carriers automatically, with complete supporting documentation.

**Key features:**

- Automatic threshold monitoring and compliant data package creation
- Multi\-carrier submission workflows
- Reduces carrier submission time from weeks to minutes

*Target users:* TPAs, self\-insured employers, stop\-loss carriers

### Real\-Time Visibility & Analytics

Live claim tracking dashboard with performance metrics and operational reporting.

**Key features:**

- Real\-time claim status tracking and performance benchmarking
- Revenue leakage detection
- Custom reporting and alerting

*Target users:* TPAs, plan administrators

## Category & focus

- Subcategories: Claims Automation, Data Normalization, Stop\-Loss Reporting
- Insurance verticals: Health, Group Benefits
- Target customers: TPAs, Carriers, Employers

## Links

- Website: <https://www.amerahealthsolutions.com>
- Directory profile: <https://insurtechlist.com/companies/amera/>
- Linkedin: <https://www.linkedin.com/company/amerahealthsolutions>
- Y combinator: <https://www.ycombinator.com/companies/amera>

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*Last updated: 2026\-05\-17*