Short-Term Disability Claims Processor (REMOTE)

At OneAmerica, we deliver on promises when customers need us most. We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals. We keep our promises, so we can help them achieve their goals and realize their definition of financial success.

The STD Claims Examiner is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our client companies and the Claims department. This individual will be responsible for managing appropriate adjudication of short-term disability claims in accordance with policy provisions. The STD Claims Examiner will initiate and facilitate case management as well as other ancillary services to assure optimum outcomes.

Promote a positive customer service image through prompt, accurate and courteous responses to customer information needs

Consistently adhere to the documented workflow guidelines and established procedures.

Demonstrate competency in all modules of training program. Promptly and thoroughly investigate and evaluate claims within departmental and regulatory guidelines

Interpret and administer contract provisions including, but not limited to, eligibility, covered weekly earnings, definition of Total Disability, verification of applicable offsets and pre-existing investigations

Processes financial activities, including, but not limited to, payment adjustments, stop payments, voids and check reissues, other income adjustments, reimbursement checks, and final benefits. Work in coordination with an LTD Examiner to ensure an appropriate transition from the STD claim to LTD

Document claim file actions and telephone conversations appropriately

Refer claim activity outside authority level to Supervisor/Manager for review

Utilize most efficient means to obtain claim information

Fully investigates all relevant claim issues, provides payment or denials promptly and in full compliance with departmental procedures and Unfair Claims Practice regulations

Respond to customer service issues within required timeframes

Involve technical resources (Social Security Specialist, medical resources and vocational resources) at appropriate claim junctures

Meet or exceed departmental service, quality and production objectives

0-2+ years of experience in managing Short Term Disability claims with first pay authority

Ability to fluently speak and write Spanish a plus

Excellent customer service skills

Ability to analyze complex claim information

Working knowledge of Microsoft Excel and Word

High School Diploma required, or any combination of education and experience which would provide an equivalent background.

The candidate will also be expected to physically return to the office in CA, IN or ME as business needs dictate or for team-building and collaboration.

If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York.

OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual’s race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law.

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.J-18808-Ljbffr OneAmerica Financial