Std Benefit Claim Specialist (Workplace Solutions)

As a vital member of our team, you will be responsible for making informed decisions throughout the life of insurance claims, from initial adjudication to ongoing claims management. Working in collaboration with management, you will leverage claim facts and conduct thorough evaluations, gathering pertinent information to formulate appropriate action plans.

WHAT WE CAN OFFER YOU:

• Estimated Wage (Levels have variable responsibilities and qualifications):
  • Benefit Claim Specialist: $22.50 - $27.88/hr plus annual bonus opportunity.
  • Sr Benefit Claim Specialist: $49,920- $63,700 plus annual bonus opportunity.
  • Lead Benefit Claim Specialist: $56,150 - $72,810 plus annual bonus opportunity.
• Benefits and Perks, 401(k) plan with a 2% company contribution and 6% company match.
• Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
• Regular associates receive 11 paid holidays in 2024, which includes 2 floating holidays that are added to your prorated personal time to be used at your discretion.
• Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 40 hours of personal time in 2024, which is prorated based on the start date. Additionally you will receive two floating holidays in 2024 by way of personal time that may be used at your discretion.
• Applicants for this position must not now, nor at any point in the future, require sponsorship for employment.

WHAT YOU'LL DO:

• Make decisions in partnership with management based on a comprehensive understanding of claim facts and thorough evaluation of relevant information.
• Develop case files that showcase sound decision-making in accordance with documented procedures, using claim facts, policy provisions, and special handling agreements. Foster effective business relationships through clear communication with claimants, brokers, sales organizations, vendor partners, employers, and internal departments such as underwriting and legal.
• Thoroughly document all claim decisions and actions meticulously, maintaining regular and appropriate communication with claimants, employers, and medical professionals throughout the entire claims life cycle
• Review and determine ongoing claim liability, involving the evaluation of claim documentation, resolution of queries, and identification of any changes in claim status or benefits. Collaborate with internal and external partners, including brokers, sales organizations, clinical and physician resources, vocational experts, and financial resources
• Accurately determine financial liability by analyzing salary, other income sources, medical/vocational information, and contract language. Exercise limited autonomy to approve initial and ongoing payments based on a holistic file evaluation.

WHAT YOU’LL BRING:

• Demonstrate a foundational ability to analyze, comprehend and apply insurance provisions and contracts to disability claims.
• Provide a solid level of customer service (written and verbal) while displaying empathy to customers.
• Ability to calculate disability benefits based on contract provisions and offset management to provide fair, equitable and consistent treatment of claims necessary for accurate financial payments and policyholder retention and satisfaction.
• Proficient with personal computers and Microsoft applications.
• Possess strong organizational, critical thinking and analytical skills with attention to detail and an increasing degree of accuracy. Ability to work somewhat independently and apply a sense of urgency to customers and decision making.
• You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

PREFERRED:

• College degree or equivalent industry experience.
• 3+ years of experience processing disability claims.

We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply!

If you have questions about your application or the hiring process, email our Talent Acquisition area at careers@mutualofomaha.com. Please allow at least one week from time of applying if you are checking on the status.

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