Long Term Care Benefit Claim Specialist - Remote

The Individual Long Term Care Department has an immediate opening for a seasoned Long Term Care Benefit Claim Specialist. This role will ensure the seamless, accurate, and timely management of Long Term Care disability claims from start to finish. As a vital player in this area, you'll analyze claims, make informed decisions, and communicate effectively with claimants, employers, and medical professionals. Your focus on precision and efficiency ensures compliance with regulations while delivering an exceptional customer experience.

With a balance of independent decision-making and collaborative communication, you'll determine eligibility, detect fraud, and manage financials. Your work will directly influence business success, ensuring retention and financial stability through expert claims handling.

WHAT WE CAN OFFER YOU:

• Hourly Wage: $22.50 - $25.00, 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:

• Collaborates with management to make informed decisions throughout the claim's lifecycle, from initial adjudication to ongoing management, ensuring effective action plans based on claim facts.
• Establishes strong relationships with claimants, employers, brokers, vendors, and internal teams, delivering professional, customer-focused communication that aligns with Mutual of Omaha's values.
• Thoroughly documents actions and decisions, ensuring transparency and compliance with policies, ERISA, and other relevant regulations, while staying current on industry and legislative changes.
• Accurately evaluates financial liability and eligibility based on salary, policy terms, and medical/vocational data, coordinating payments and benefit changes as needed.
• Initiates regular communication with stakeholders, provides status updates, resolves claim issues, and generates detailed reports per contract requirements.

WHAT YOU'LL BRING:

• Strong Long Term Care claims processing/claim management
• Develops foundational skills in analyzing insurance contracts, applying regulations, and understanding medical terminology relevant to claims.
• Provides solid written and verbal support, with the ability to diffuse situations and communicate effectively with stakeholders, with strong organizational abilities, attention to detail, and deadline management.
• Progresses from dependent to independent decision-making with growing analytical and critical thinking skills to manage long-term claims accurately and fairly.
• Maintains attendance expectations, adapts to change, and manages claims efficiently to ensure policyholder satisfaction and financial consistency.
• 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:

• Seasoned Long Term Care claims processing experience;
• 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!

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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