Mutual of Omaha Looking for Long Term Care Benefit Claim Specialist/Sr. Specialist (Remote) at Omaha, NE  Full Time

Ensures 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.

Performs end-to-end claims evaluation, management and adjudication for Disability claims beginning at the point of notification through the maximum benefit/duration of the claim with the primary accountability being accurate and timely decision making of approved or denied liability benefits for the duration of the claim by managing to the appropriate duration based upon the claim facts, effective and efficient claim management, as well as communication of decisions both verbally and in writing to claimants and employers.

Requires independent decision making on less complex claims situations and some 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 Salary (Levels have variable responsibilities and qualifications)
  • Benefit Claim Specialist: Minimum: $22.00 MidPoint: $27.88 Maximum: $33.75, plus annual bonus opportunity
  • Sr. Benefit Claim Specialist: Minimum: $49,920 MidPoint: $63,700 Maximum: $77,480, 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:

• Collaborates with management for informed claim decisions based on thorough evaluation.
• Maintains comprehensive case files, demonstrating adherence to procedures and policy provisions.
• Cultivates professional relationships with stakeholders for effective communication.
• Documents actions and rationales meticulously for transparency and review.
• Manages claim liability, coordinating with various partners for resolution and communicates changes promptly.

WHAT YOU’LL BRING:

VALUABLE EXPERIENCE:

• College degree or equivalent industry experience
• Previous long term care claims processing skills

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 , email our Talent Acquisition area at . Please allow at least one week from time of applying if you are checking on the status.