Field Claims Consultant

About the role

Summary Field Claim Consultants are remote employees who conduct video, telephone, and in-person interviews (requiring travel), to evaluate and analyze the most complex contestable and non-contestable, Disability Income, Life, Long Term Care and Life Waiver of Premium claims. They interpret, analyze, and identify pertinent facts in accordance with policy provisions, state regulations and claims procedures and standards to assist with claim evaluation. Where necessary, they consult with Directors, Assistant Directors of Claims Division, Field Claims Consultant (FCC) Manager or referring Analysts, Specialists or Consultants to ensure appropriate and timely handling of the claim.

Responsibilities

• Acts as a consultant for the DI Claims Department which involves conducting video, telephone and in-person interviews, requiring travel to the insured’s requested location.
• Acts as a consultant to investigate contestable death claims for Life Benefits, which includes conducting phone and in-person interviews with Next of Kin, policyowner, beneficiaries etc.
• Acts as a consultant for the DI Claims Department assisting with settling and negotiating Overpayments of benefits and conducting interview when needed.
• Handles NM Group Claims, LTC, Compliance, Law and other areas of the company, as requested.
• Acts in an investigative capacity leveraging a specialized skillset to assist the SIU with investigations including suspected fraud, diminished capacity, elder abuse, welfare checks and locating missing sources.
• Settlement authority up to $250,000 and can meet in-person with policyowners, insured’s or their legal representatives to negotiate and resolve claims.
• Provides detailed written reports on all interviews conducted, that must be clear, accurate, and concise.
• Prepares and attaches accurate file documentation on claims related to referrals.
• Promotes NM’s brand and image as the face of the company during interactions with policyholders.
• Responsible for effective claim handling and evaluation of contestable and non-contestable, Disability Income, Life and Accidental Death Benefit, Life Waiver of Premium, Long-Term Care, claims through thorough and timely contact with Policyowners, Insureds, Physicians, business partners, and other parties.
• Skillful collaboration with colleagues across all levels in diverse claims scenarios, including pending, active, terminated, appeals, overpayments, suspected fraud, Carpe Data, CDC’s, diminished capacity, and financial abuse.
• Aid the Law Department and outside counsel when litigating cases through gathering and preparing necessary information and participating in depositions.
• Aid Market Conduct with field investigations when circumstances require FCC involvement.
• Preserve NM's image and reputation in the obtaining of the necessary facts so as to permit approval, denial, or compromise of claims consistent with NM's claim philosophy, despite difficult and delicate circumstances.
• Participate in the training and performance evaluation of new FCCs. Act as mentor to FCC(s) and other business line customers.
• Act as a resource to the FCC staff on use of the laptop computer and other equipment assigned to them.
• Prepare timely and thorough written reports of activities performed to assist analysts and managers in administration of the claim or insurance matters.
• Resolve claims through skillful negotiation with policyowners, Insureds or their legal representatives by being sensitive to the rights of the other party, by protecting the Company and its policyholders from overpaying fraudulent or non-compensable claims.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum of 5 years of complex disability or life claims handling experience demonstrating analytical ability, independent decision making and sound judgment, or equivalent analytical experience.
• Investigative background is desired.
• Excellent written and oral communication skills including the ability to handle complex interpersonal situations.
• Demonstrated ability to work independently, utilizing time management skills to set priorities and complete assignments in a timely manner.
• Ability to adapt quickly and remain agile in response to ongoing changes in digital systems, contracts, financial updates, and tax regulations.
• Proficiency with laptop computers and utilizing software such as MS Office, Word, Excel, Outlook, Zoom, Slack, Dragon, and other technologies.
• Proficiency in conducting research utilizing the internet.
• Ability to travel by air, rail or vehicle and work nights/weekends when required.
• Ability to coordinate and manage travel logistics and expense management related to in-person interviews or other company required activities.
• Completion of industry courses as required by company.
• Demonstrate a high level of integrity.
• Excellent personal financial management and credit history.
• Satisfactory driving record required for travel. Proof of auto insurance is required.

Benefits

The compensation range for this role is $81,280.00 to $121,920.00 USD. Northwestern Mutual offers a comprehensive benefits package including:

• Flexible work schedules
• Concierge service
• Comprehensive benefits
• Employee resource groups

We believe in fairness and transparency. It’s why we share the salary range for most of our roles. However, final salaries are based on a number of factors, including the skills and experience of the candidate; the current market; location of the candidate; and other factors uncovered in the hiring process.

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