Claims Associate - Long Term Care

At One America 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.

• Independently adjudicate a broader range of claims, includingშემcomplex documentation or benefit triggers.
• Analyze provider and care documentation to determine ongoing eligibility.
• Engage with providers and families to resolve issues or obtain information.
• Mentor or support Level 1 associates.
• Identify potential red flags or inconsistencies for clinical or risk escalation.
• Take incoming calls and make outbound calls throughout the claim process.
• Must meet/maintain procedural accuracy requirements.

• High School Diploma or equivalent

• Bachelor's Degree

• 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.

Salary Band: 3B

This selected candidate will be expected to work hybrid in Indianapolis, IN or Portland, ME. 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 One America Financial does not have any offices located in the State of New York and One America Financial associates are not permitted to work remotely in the State of New York.

Disclaimer:
One America Financial is an equal opportunity employer and strictly prohibits unlawful discriminationгәк 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.

Becauseំព this position is 프로regulated 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.

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