What are the responsibilities and job description for the Claims Examiner- Individual Life Death Claims (experience required) position at Employment Opportunities?
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 Individual Life Claims Examiner 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.
Job Summary
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.
Individual Life Claims Associate is responsible for:
- Reviewing and processing Individual Life Death Claims
- Clearing outstanding accounting
- Clearing up eligibility issues
- Performing adjustments
- Level II Associates may train, mentor, and audit less experienced associates.
- Level II Associates may work with escalating claim issues with minimal leadership consultation including taking on escalated calls
Primary duties may include, but are not limited to:
- Customer Experience and support 40%
- Effectively, accurately and timely communicate/collaborate with internal and external customers in accordance customer service protocols.
- Independently investigate, collect, examine information to determine claim direction to make accurate, impartial claim determinations based on facts, policies, regulations, and department procedures, for claims including those of a complex nature.
- Appropriately and independently use problem solving measures and discretion to investigate claims by utilizing appropriate investigative tools.
- Correctly calculates and processes claim benefit payments due within authority level.
- Prepares quality communication to agents, policy owners, insureds, beneficiaries, policyholders, medical providers, or other customer and business relationship parties.
- Identify, understand, and appropriately refer matters to legal counsel or escalates claim issues with minimal leadership consultation.
- Performance and Service expectations: 50%
- Maintains or exceeds departmental deadlines, requirements, service, accuracy, timeliness, and performance standards. Completes correct accounting transactions and clearing according to departmental procedures.
- Process Improvement 10%
- Demonstrate EWA and support of the OneAmerica Ways.
Required Work Experience:
- Minimum 3-5 years experience managing life death claims required
- Experience interpreting policy language; training experience helpful
- Strong written and verbal communication skills
- Experience working with Microsoft Office applications
Required Education and/or Certifications:
- High School Diploma or GED. Bachelor's Degree preferred in Business Management, Operations Management, Statistics, or Insurance.
Recommended Education and/or Certifications
- LOMA
We are currently seeking Level I & II Representative experience.
#LI-SC1
Salary Band: 3B
This selected candidate will be expected to work hybrid in Indianapolis, IN but we may consider remote associates who are not local to Indianapolis, IN. 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.
Consistent with applicable pay transparency laws, we disclose the compensation range for this position: $21.63 - 36.06 hourly. Actual compensation will be determined by factors such as education, experience, geographical location, and other job-related factors permitted by law. In addition to base pay, this role is eligible for an annual incentive program.
We offer a comprehensive total rewards package designed to support you both at work and at home. Full‑time and part‑time associates working 30 or more hours per week are generally eligible for benefits, including but not limited to:
- 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)
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.
Selected employees must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship.
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.
Salary : $22 - $36