Claims Associate - Long Term Care
About The Position
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! The Long-Term Care Claims Associate is responsible for helping our customers maintain a sense of security by independently and effectively managing an assigned caseload of claims, in a fair and ethical manner and within all requirements and service standards.
Requirements
- High School Diploma or equivalent
- 1+ years of LTC claims or related experience.
- Intermediate knowledge of long-term care services and terminology.
- Demonstrated ability to manage multiple cases with accuracy and empathy.
Nice To Haves
- Bachelor's Degree
Responsibilities
- Independently adjudicate a broader range of claims, including some with complex documentation or benefit triggers.
- Analyze provider and care documentation to determine ongoing eligibility.
- Engage with providers and families to resolve issues or obtain information.
- Mentoring or supporting of Level 1 associates.
- Identify potential red flags or inconsistencies for clinical or risk escalation.
- Taking incoming calls and making outbound calls throughout the claim process.
- Must meet/maintain procedural accuracy requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
