Long Term Care Claims Examiner
OneAmerica
At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives!
Job Summary The Long Term Care Claims Associate is responsible for adjudicating less complex long-term care claims with close supervision and support. Focuses on learning systems, policy interpretation, and documentation standards while delivering compassionate customer service. Primary duties may include, but are not limited to:- Adjudicate routine claims according to policy and regulatory guidelines.
- Request and review basic medical records and care plans.
- Communicate claim status and decisions to claimants and providers.
- Document all actions clearly and accurately in the claim system.
- Participate in training and coaching to build foundational LTC knowledge.
- Taking incoming calls and making outbound calls throughout the claim process.
- Must meet/maintain procedural accuracy requirements.
- 0–2+ years of insurance or healthcare experience.
- Critical thinking and analytical skills.
- Strong written and verbal communication skills.
- Detail-oriented with the ability to follow structured procedures.
- Accuracy within the claim review process.
- Timeliness of claim processing.
- Customer engagement satisfaction and empathy in interactions.
- Demonstrate the ability to increase proficiency and skill levels.
- Medical & prescription, dental, vision insurance
- Health Savings Account & Flexible Spending Accounts
- Paid Time Off
- 10 weeks 100% paid parental leave (after completing 12 months of employment)
- 401(k) Plan with company match
- Pension Plan
- Company paid life & disability insurance
- Wellness Program & Company paid employee assistance program
- Clinic access subject to location* (*Indianapolis, Charlotte, Cincinnati)
Disclaimer: American United Life Insurance Company (“OneAmerica Financial”) is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, gender identity), age, physical or mental disability, veteran or military status, genetic information, citizenship, or any other legally recognized protected basis under federal, state, or local law. For all positions: Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered. To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies. Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
Vacancy posted more than 2 months ago
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