Hybrid STD Claims Examiner

Employment Opportunities; South Portland, Indianapolis (ME, IN); Hybrid; USD 36,000 - 59,000; Full time

Benefits offered by this job

Medical Insurance

Dental & Vision

Health Savings Account

Flexible Spending Accounts

Paid Time Off

401(k) Plan with company match

Pension Plan

Life & Disability Insurance

Wellness Program

Employee Assistance Program

Job summary

OneAmerica is seeking a STD Claims Examiner to support short-term disability claims with a focus on accuracy and timely resolutions. The role combines in-office work in Indianapolis with potential remote options for Portland, ME, aligning with business needs.

Responsibilities include adjudicating claims, calculating benefits, and collaborating with medical and legal resources to ensure compliant outcomes, in a structured, customer-focused environment.

Qualifications

• BA/BS or equivalent combination of education and experience.
• 5+ years of experience in managing Short Term Disability claims with first pay authority.
• Fluent or proficient in Spanish a plus.
• Strong math/calculation skills and analytical ability.
• Proficient in Excel and Word for claim management and documentation.

Responsibilities

• Promotes a positive customer service image through prompt, accurate and courteous responses to customer information needs.
• Investigates and evaluates claims within guidelines and administers policy provisions.
• Calculates benefit, handles payments, adjustments and reimbursements accurately.
• Communicates with claimants, policyholders and physicians to resolve issues and manage expectations.
• Coordinates with specialists to ensure appropriate claim outcomes and timely processing.

Skills

Excellent math and calculation skills

Decision making

Spanish language

Microsoft Excel

Microsoft Word

Education

BA/BS or equivalent combination of education and experience

Tools

Microsoft Excel

Microsoft Word

Job description

OneAmerica is seeking a STD Claims Examiner to support short-term disability claims with a focus on accuracy and timely resolutions. The role combines in-office work in Indianapolis with potential remote options for Portland, ME, aligning with business needs.

Responsibilities include adjudicating claims, calculating benefits, and collaborating with medical and legal resources to ensure compliant outcomes, in a structured, customer-focused environment.