Mutual of Omaha STD Claims Analyst/Sr STD Claims Analyst (STD All Products) - multiple positions in Omaha, Nebraska
For over 100 years, Mutual of Omaha has been known nationally as a reliable, trustworthy, knowledgeable and caring company with a solid reputation built on our commitment to excellence. We are a full-service, multi-line provider of insurance and financial services products for individuals, businesses and groups throughout the United States. We are committed to providing outstanding service to our policyholders. Our commitment to customer service is the cornerstone of our vision and values.
The STD Claims department atMutual of Omaha has an immediate opening for an energetic and driven STD ClaimsAnalyst to ensure the prompt and accurate disposition of disability claims byanalyzing and determining appropriate disposition of claim relative to allshort term disability products. This position performs end to end claimsmanagement for short term disability claims beginning at the point ofnotification through the end date. The primary accountability is the accurateand timely decision of approval or denied liability benefit for the duration ofthe claims as well as communicating decisions both verbally and in writing tothe claimant and employers. The claim is analyzed to determineeligibility for benefits based on the medical information received and thecontract language. This includes but is not limited to analyzing theinformation that has been received, determining if additional information isrequired in order to make the benefit decision. This position is constantlycommunicating with employers, physicians (or other providers) and the claimant.
***This job posting is reflective of the entry level Analyst essential functions, qualifications, and physical requirements. The Sr and Specialist levels have variableessential functions, qualifications and physical requirements. Competency and skill set will determine levelof placement within the posted job family.
***This position does have theoption to telecommute.***
Essential Job Functions:
- Makes sound decisions at the time of initial adjudication.
- Reviews and determines continuing claim liability, which includes evaluating and obtaining claim documentation, resolving questions, and determining any changes in status or benefits.
- Develops file that demonstrates appropriate decision was made based on documentation.
- Develops appropriate business relationship with the claimant and the employer.
- Maintains frequent communication with the claimant and employer throughout the life-cycle of the claim.
- Communicates via telephone with employers, physicians (or other providers), and claimants.
- Determine financial liability based on salary, other income sources and contract language. Approve initial payment and determine qualification of continuing payments. Benefit periods can be from 13 - 104 weeks.
- Communicates any change in liability or claim status to both internal and external customers.
- Provides various information to policyholders per contract requirements.
- Determine eligibility based on contract language, payroll records, and other supporting documentation.
- Adhere to ERISA and other federal/state law concerning group disability insurance.
- Demonstrates flexibility and ability to support unique customer requirements.
- Creates written letters to the claimant for the purpose of providing concise explanations for claims determinations.
- Embraces process improvement and pursues ways to simplify and streamline our operations.
- The ability to perform extensive or prolonged typing/keyboarding and telephone usage.
- The ability to operate in a fast-paced, high volume environment with set production goals.
- Executesdaily activities that support our core purpose, what we do and our strategicanchors. Uses the strategic anchors to guide decision-making and prioritizationof work.
- This position requires extensive or prolonged typing/keyboarding.
- This position is in a fast-paced, high volume environment with set production goals.
- Knowledge of disability claims procedures
- Knowledge of disability and group insurance
- Knowledge of medical terminology
- Analytical and decision-making skills
- Verbal and written communication skills
- Proficient with personal computer and Microsoft applications
- Ability to maintain regular and predictable attendance in adherence to department and company attendance expectations
- May require ability to travel occasionally
- Short-term disability claim processing experience (2 or more years required).
- Ability to recognize when to escalate an issue.
- Excellent organizational skills, attention to detail with a high degree of accuracy, and the ability to work somewhat independently and apply a sense of urgency.
- Ability to adapt to a changing environment.
- Proven leadership and/or mentoring experience.
If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact a Human Resources Representative at 1-800-780-0304. We are available Monday through Friday 7 am to 4 pm CST.
For all other inquiries, contact our HR Helpline at 1-800-365-1405, option 4.
Mutual of Omaha and its affiliates are an Equal Opportunity /Affirmative Action Employer, Minorities/Female/Disabled/Veteran
Job: Claims/Call Center
Requisition ID: 029629