Group Disability Claims QA Specialist - Remote

As a Group Disability Claims QA Specialist, you will spend your day performing healthy claim reviews of our organization’s group insurance products.  Responsibilities include communicating the results of these reviews, any process changes and compliance issues to our claims staff. This role will have a significant impact on the organization by enhancing the accuracy and consistency of group claim adjudications, promoting compliance, and fostering continuous improvement within Workplace Solutions Claims Shared Services, ultimately contributing to a more reliable and customer-focused claims experience. 

WHAT WE CAN OFFER YOU:

• Estimated Salary $60,000 - $68,000, plus annual bonus opportunity.   
• Benefits and Perks, 401(k) plan with a 2% company contribution and 6% company match.
• Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
• Regular associates receive 11 paid holidays in 2025, which includes 2 floating holidays that are added to your prorated personal time to be used at your discretion.
• Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 40 hours of personal time in 2025, which is prorated based on the start date. Additionally you will receive two floating holidays in 2025 by way of personal time that may be used at your discretion.
• Applicants for this position must not now, nor at any point in the future, require sponsorship for employment. 

WHAT YOU'LL DO:

• Drive quality and accuracy by analyzing, evaluating, and auditing claims adjudication across a variety of products, including Short-Term and Long-Term Disability, Life, Life Waiver of Premium, Accidental Death & Dismemberment, Critical Illness, Hospital Indemnity, Paid Family Leave and more within Workplace Solutions. 
• Champion accuracy and consistency by adhering to established supervisor and Healthy Claim Review processes, conducting thorough quality checks on the work of Benefit Claim Technicians and Benefit Claim Specialists. 
• Be a mentor and resource by participating in training, coaching, and providing constructive feedback to Benefit Claim Technicians, Specialists, and Claims Leadership, promoting best practices and continuous improvement in claims management. 
• Stay ahead of the curve by keeping up-to-date with industry developments, regulatory changes, and evolving company processes, ensuring compliance and knowledge-sharing with your team. 
• Make a meaningful impact by identifying and eliminating inefficiencies in our processes, focusing on high-value service for our customers. Collaborate on innovative process improvements and effectively communicate these changes and compliance updates to the team. 

WHAT YOU’LL BRING:

• 5+ plus years of Group Disability Claims experience, where you made autonomous decisions throughout the life of the claim (initial adjudication and ongoing claims management) based upon claim facts, thorough evaluation and gathering of pertinent information to formulate appropriate action plans.
• Demonstrated experience with the application of policies, practices, and procedures in a business environment with the ability to review, reflect and express the opportunities that are presented in a claims file and the ability to be confident in your decision making. 
• Excellent organizational skills and high attention to detail with strong independent work ethic. 
• Experience mentoring or coaching in group claims. 
• You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do. 

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 careers@mutualofomaha.com. Please allow at least one week from time of applying if you are checking on the status.

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