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STD Benefit Claim Specialist (Workplace Solutions) - Omaha, NE, Chattanooga, TN, Portland, ME or Re

Mutual Of Omaha

Mutual Of Omaha

United States
Posted on Tuesday, September 12, 2023

The Workplace Solutions Division has immediate openings for detail oriented and organized Benefit Claim Specialists to ensure the accurate, prompt and thorough evaluation and management of disability claims by analyzing and determining the appropriate action steps while adhering to both internal and external regulations and ensuring an industry-leading customer experience. This role has direct impact on the success of Workplace Solutions from both a financial and persistency (customer retention) perspective.

Class starts on Monday, November 27th.  Training hours are 7:30-4:00 CST for up to 9 weeks. 

This position requires independent decision making on complex claims situations and critical thinking. Claims analysis includes: eligibility determination for initial and ongoing benefits based on medical information received, contract analysis, customer service, fraud detection and awareness, financial calculations, interpreting medical and vocational information and adhering to all statutory/governmental regulations. This includes analyzing information received and determining if additional information is required to make a benefits decision. Regularly communicates with employers, medical professionals (including physicians) and claimants.

WHAT WE CAN OFFER YOU:

  • Estimated Hourly Wage: $19.75 - $30.00, plus annual bonus opportunity. 
  • 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 9 paid holidays in 2023.
  • Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 56 hours of personal time in 2023, prorated based on the start date.

WHAT YOU'LL DO:

  • You'll make decisions in partnership with management throughout the life of the claim (initial adjudication and ongoing claims management) based upon claim facts, thorough evaluation and gathering of pertinent information to formulate appropriate action plans.
  • Develops case files that demonstrate appropriate decision making based on documented procedures using claim facts, pertinent policy provisions, customer expectations and special handling agreements through appropriate business relationships and communications with claimant, broker, sales organization, vendor partners, employer and internal partners (e.g. underwriting, legal, etc.). Communications demonstrate a solid level of customer service and professionalism that support the values of Mutual of Omaha.
  • Thoroughly documents all claim decisions and actions of claim management with regular and appropriate verbal and written communication with claimants, employers and medical professionals throughout the life-cycle claims. This includes initial and ongoing claim decisions.
  • Reviews and determines continuing claim liability, which includes evaluating and obtaining claim documentation, resolving questions, and determining any changes in claim status or benefits. Requires interaction and coordination with internal and external partners including brokers, sales organization, clinical and physician resources, vocational experts, vendor partners and financial resources.
  • Accurately determines financial liability based on salary, other income sources, medical/vocational information and contract language by determining eligibility based on contract language, payroll records and other supporting documentation Has limited autonomy to approve initial and ongoing payments based upon holistic file evaluation. Role is responsible for accurate and timely claims management.

WHAT YOU’LL BRING:

  • Demonstrate a beginning level ability to analyze, comprehend and apply insurance provisions and contracts to disability claims.
  • Ability to 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 computer, Microsoft applications and Mutual of Omaha proprietary applications.
  • Good organizational, critical thinking and analytical skills. Attention to detail with a increasing degree of accuracy and the ability to work somewhat independently and apply a sense of urgency to customers and decision making.
  • Ability to meet deadlines while being able to move from dependent to independent 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.

VALUABLE EXPERIENCE:

  • 2 years of disability or claims experience highly desired. 
  • College degree or equivalent industry experience.

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

After applying, for inquiries about your application or the hiring process, please email our Talent Acquisition area at careers@mutualofomaha.com.