Long Term Care Claims Examiner

Job Summary

The Long Term Care Claims Associate is responsible for adjudicating less complex long-term care claims with close supervision and support. They focus on learning systems, policy interpretation, and documentation standards while delivering compassionate customer service.

Primary Duties

• Adjudicate routine claims according to policy and regulatory guidelines.
• Request and review basic medical records and care plans.
• Communicate claim status and decisions to claimants and providers.
• Document all actions clearly and accurately in the claim system.
• Participate in training and coaching to build foundational LTC knowledge.
• Taking incoming calls and making outbound calls throughout the claim process.
• Must meet/maintain procedural accuracy requirements.

Required Education and/or Certifications

• A High School Diploma or equivalent.
• A Bachelor's Degree is recommended.

Work Experience

• 0–2+ years of insurance or healthcare experience.
• Critical thinking and analytical skills.
• Strong written and verbal communication skills.
• Detail-oriented with the ability to follow structured procedures.

Key Performance Indicators

• Accuracy within the claim review process.
• Timeliness of claim processing.
• Customer engagement satisfaction and empathy in interactions.
• Demonstrate the ability to increase proficiency and skill levels.

Salary Band

$21.16 – $32.45 per hour.

Benefits

• 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(k) Plan with company match.
• Pension Plan.
• Company paid life & disability insurance.
• Wellness Program & Company paid employee assistance program.
• Clinic access subject to location.

Location

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.

Compensation

Consistent with applicable pay transparency laws, we disclose the compensation range for this position: $21.16 – $32.45 per hour. 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.

Equal Opportunity Employer

OneAmerica Financial is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, gender identity), age, physical or mental disability, veteran or military status, genetic information, citizenship, or any other legally recognized protected basis under federal, state, or local law.