| As a vital member of our Long Term Care team, you will be responsible for making informed decisions throughout the life of Long Term Care claims, from initial adjudication to ongoing claims management. Working in collaboration with internal resources, you will leverage claim facts and conduct thorough claim evaluations, gathering pertinent information to formulate appropriate action plans. |
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WHAT WE CAN OFFER YOU:
- Estimated Hourly Wage: $22.50 - $26.00/hr., 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.
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WHAT YOU'LL DO:
- Reviewing and interpreting policy provisions, gathering necessary medical evidence to arrive at a timely decision. Exercise limited autonomy to approve initial and ongoing payments based on a holistic file evaluation.
- You will be responsible for the full life cycle of the claim from inception to completion. Review and determine initial and ongoing claim eligibility.
- Collaborate with internal and external partners, including brokers, sales organizations, clinical and physician resources, vocational experts, and financial resources.
- Develop case files that showcase sound decision-making in accordance with documented procedures, using claim facts, policy provisions, and special handling agreements.
- Demonstrates a solid level of customer service and professionalism through the building of relationships that supports the values of Mutual of Omaha.
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WHAT YOU’LL BRING:
- Demonstrate a foundational ability to analyze, comprehend and apply insurance provisions and contracts to long term care claims.
- Provide a solid level of customer service (written and verbal) while displaying empathy to customers.
- Ability to apply decision making 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.
- Proficiency in using 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.
- Ability to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.
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PREFERRED:
- Long Term Care claims processing experience.
- College degree or equivalent industry experience.
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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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