Manager STD Claims

Reposted 8 Days Ago
Be an Early Applicant
South Portland, ME, USA
Hybrid
80K-133K Annually
Senior level
Fintech • Insurance
The Role
Leads short-term disability claims operations, ensuring timely, accurate, compliant claim decisions and strong customer service. Manages claims staff performance, coaching, staffing, retention, workload distribution, quality reviews, complaints, and adherence to ERISA and service guidelines. Partners with supervisors and cross-functional teams including appeals, training, legal, underwriting, and policy teams. Participates in recruiting, employee development, customer presentations, and initiatives that improve claims effectiveness and business results.
Summary Generated by Built In

At OneAmerica, we deliver on promises when customers need us most.  We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals.  We keep our promises, so we can help them achieve their goals and realize their definition of financial success.

The Manager, STD Claims is responsible for contributing to the overall success of OneAmerica’s objectives by providing timely and accurate support to our policy holders and the Claims department. This role will focus on meeting all key financial business objectives and enhance customer service levels for assigned team. The Manager, Short-Term Disability Claims will focus on effectively managing the performance of all individuals to achieve optimal productivity and strive for quality through accurate and timely claim decisions This individual will also maintain clear and ongoing communications with other business partners, inside and outside of claim department, such as QA, Appeals, Training Team, Program Managers, Policy and Procedures, Underwriting, Legal, etc.  

The purpose of the Manager, Short-Term Disability Claims is to provide leadership and coaching to claims staff and maintain a positive impact on employee staffing and retention levels by participating in recruiting, hiring and retention strategies.

KEY RESPONSIBILITIES:

  • Consistently adhered to the documented workflow guidelines and established procedures.
  • Assured consistent, quality claims handling by review of pending claim, diary and Change of Definition reports.
  • Responds to and tracks all Insurance Department complaints.
  • Actively participates in review of claims for approvals/denials.
  • Conducts one-on-one meetings with all claims staff on a monthly basis.
  • Conducts timely, accurate performance assessments for all team members. Such assessments include a 6-month interim as well as an annual performance review.
  • Partners with Supervisors in mentoring all staff to acceptable proficiency levels.
  • Personally documents and addresses all performance management issues and communicates those to the Director of Claims.
  • Interfaces weekly with Supervisor to remain abreast of team member performance and on-going training needs.
  • Monitors caseloads to maintain consistency within team.
  • Analyzes claim activity reports to ensure adherence to turn-around times, workflow guidelines, etc.
  • Supports/develops supervisors’ technical and mentoring capabilities.
  • Ensures the Team provides excellent customer service by appropriately adjudicating claims within established service protocols.
  • Responds to and documents customer complaints from claimants/their representative, clients and policyholders
  • Ensures quality claim decisions in accordance with ERISA requirements and fair claim practices through participation in Team Meetings.
  • Participates in customer presentations and visits with the goal of retaining existing customers and attaining new customers at the request of the Director of Claims.
  • Reaches or exceeds approved quality rating requirements.
  • Displays a high level of leadership through employee development, coaching and performance management.
  • Strives to timely utilization of appropriate resources across the benefits organization.
  • Participates in cross-departmental initiatives to enhance the overall effectiveness of the company at the request of the Director of Claims.

REQUIREMENTS:

  • Four-year college degree or a combination of equivalent related work experience and education.
  • A minimum of 5 years of experience managing disability claims strongly preferred.
  • Prior managerial experience required.
  • Desired designations include: ICA (Insurance Claims Associate); HIA (Health Insurance Associate); LOMA, FLMI (Fellow Life Management Institute); CEBS (Certified Employee Benefit Specialist); etc.

#LI-SC1

Salary Band: 06B

This selected candidate will be expected to work hybrid in 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.

Consistent with applicable pay transparency laws, we disclose the compensation range for this position: $79,500 - 132,500 annually. 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(k) Plan with company match
  • Pension Plan
  • Company paid life & disability insurance
  • Wellness Program & Company paid employee assistance program
  • Clinic access subject to location* (*Indianapolis, Charlotte, Cincinnati)

If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York.

Selected employees must be able to perform the essential functions of the position satisfactorily and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions of their job, absent undue hardship. 

Disclaimer:  American United Life Insurance Company (“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.

For all positions:

Because this position is regulated 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.

To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Skills Required

  • Four-year college degree or equivalent combination of related work experience and education
  • At least 5 years of experience managing disability claims
  • Prior managerial experience
  • ICA, HIA, LOMA, FLMI, CEBS, or similar insurance designations
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The Company
HQ: Indianapolis, IN
2,033 Employees
Year Founded: 1877

What We Do

In a world where stability can be hard to find, you can count on the companies of OneAmerica®. We provide retirement and employee benefit plans, individual life insurance, annuities and asset based long-term care solutions on a more than 140-year foundation of strength. We continue to thrive and grow by keeping our commitments to stability and ongoing policyholder value. As a mutual organization, we have no shareholders. We are accountable only to those who depend on us. That means our priority is serving you — the people and businesses on “Main Street.”

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