Long Term Care Benefit Claim Specialist – Remote

We are seeking a detail-oriented Disability Claims Specialist to manage end-to-end evaluation and adjudication of disability claims. This role involves analyzing medical and vocational information, making timely and accurate benefit decisions, and ensuring compliance with regulatory and contractual requirements. You’ll play a key role in supporting financial performance and customer retention by delivering exceptional service and sound claims decisions. Responsibilities include ongoing eligibility assessments, fraud awareness, and regular communication with claimants, employers, and medical professionals. Critical thinking and independent decision-making are essential for success in this role. WHAT WE CAN OFFER YOU: Hourly Wage: $22.75 - $27.00, plus annual bonus opportunity. 401(k) plan with a 2% company contribution and 6% company match. Work-life balance with vacation, personal time and paid holidays. See our benefits and perks page for details. Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. WHAT YOU'LL DO: Manages Claims Lifecycle: Partners with management to make informed decisions throughout the claim, from initial adjudication to ongoing management, based on thorough analysis and policy provisions. Builds and Maintains Relationships: Effectively communicates with claimants, employers, medical professionals, brokers, and internal teams to ensure coordinated, customer-focused claims handling. Evaluates and Documents Claims: Reviews eligibility and financial liability using medical, vocational, and contract data, while documenting actions and rationales clearly for transparency and review. Ensures Compliance and Communication: Adheres to ERISA and regulatory requirements, communicates claim status updates, and provides timely reports and written determinations to stakeholders. Stays Informed and Adaptable: Maintains up-to-date knowledge of industry trends, legislation, and internal processes, while demonstrating flexibility to meet unique customer needs. WHAT YOU’LL BRING: Demonstrates a foundational understanding of insurance contracts, disability benefit calculations, and applicable regulations, with growing proficiency in analytical and decision-making skills. Provides solid verbal and written customer service, with the ability to de-escalate situations and maintain professional communication with all stakeholders. Proficient in Microsoft Office and internal systems (e.g., GSAP, Fineos), with basic knowledge of medical terminology and experience in data entry, email, and presentations. Strong attention to detail, ability to prioritize, meet deadlines, and work with increasing independence in a dynamic environment. Shows progress toward independent decision-making, maintains consistent attendance, and ensures fair, accurate, and consistent claims handling to support customer satisfaction and retention. You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do. Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico. PREFERRED: Specific Long Term Care Claims processing skills and experience Claim file development Disability claims experience College degree or equivalent industry experience We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply! If you have questions about your application or the hiring process, email our Talent Acquisition area at [email protected]. Please allow at least one week from time of applying if you are checking on the status. Stay Safe from Job ScamsMutual of Omaha only accepts applications from mutualofomaha.com/careers. Legitimate communications will come from '@mutualofomaha.com.' We never request sensitive information or extend job offers without conducting interviews. For more details, check our Hiring FAQs. Stay alert for scams and apply securely! Fair Chance Notices #Circa