Manager, Long-Term Disability Claims – South Portland, ME

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 Manager, LTD Claims is responsible for contributing to the overall success of OneAmerica objectives by providing timely and accurate support to our customers and the Claims department. This individual will focus on meeting all key financial business objectives and enhance customer service levels for assigned team; effectively managing the performance of all individuals to achieve optimal productivity; maintaining clear and ongoing communications with other business partners, inside and outside of the Claims department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc.


KEY RESPONSIBILITIES:

  • Consistently adhere to the documented workflow guidelines and established procedures.
  • Assure consistent, quality claims handling by review of pending claim, diary and Change of Definition reports.
  • Respond to and track all Insurance Department complaints.
  • Actively participate in review of claims for approvals/denials.
  • Conduct one-on-one meetings with all claims staff on a monthly basis to assess performance.
  • Document and address all performance management issues and communicate those to the Director of Claims.
  • Monitor caseloads to maintain consistency within team.
  • Analyze claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc.
  • Ensure the team provides excellent customer service by appropriately adjudicating claims within established service protocols.
  • Respond to and document customer complaints from claimants/their representatives, clients, and policyholders
  • Ensure quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings.
  • Participate in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims.
  • Reach or exceed approved quality rating requirements.
  • Display a high level of leadership through employee development, coaching and performance management.
  • Strive to timely utilization of appropriate resources across the benefits organization.
  • Participate in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims.

REQUIREMENTS:

  • Four-year college degree or a combination of equivalent related work experience and education.
  • A minimum of 5 years’ experience managing disability claims.
  • Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc.

To learn more about our products, services, and the companies of OneAmerica, visit oneamerica.com/companies.

Disclaimer: OneAmerica 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.

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