Claims Associate - Individual Life
OneAmerica FinancialAbout the role
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 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.
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 Claims
- Clearing outstanding accounting
- Clearing up eligibility issues
- Performing adjustments
- Level II Associates may train, mentor, and audi 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.
Job Requirements
Required Education and/or Certifications
- High School Diploma or GED. Bachelor's Degree preferred in Business Management, Operations Management, Statistics, or Insurance. Prior experience within a claim operation is preferred. Knowledge of insurance administration terms and processes are a plus. Desired minimum of 2-4 years’ work experience.
Recommended Education and/or Certifications
- LOMA
Required Work Experience
- Customer Service, and experience working with Microsoft applications
- Or any combination of education and experience which would provide an equivalent background
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(
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