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
At a Glance
- Founded
- 2025
- Headquarters
- Seattle, Washington
- Employees
- 1-10
- Funding
- Seed
Category & Focus
- Category
- Claims Technology
- Subcategories
- Claims Automation Data Normalization Stop-Loss Reporting
- Insurance Verticals
- Health Group Benefits
- Target Customers
- TPAs, Carriers, Employers
Links
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Last updated: 2026-05-17