Lead Long Term Disability Claims Specialist

About the role

The Lead LTD Claims Specialist manages the most complex long-term disability (LTD) claims, ensuring accurate and compliant decisions. This role plays a crucial part in delivering a high-quality customer experience and contributes to continuous improvement initiatives.

Responsibilities

• Lead the management of complex LTD claims by exercising independent judgment to make accurate, timely, and compliant decisions.
• Create thorough claim documentation and correspondence by analyzing medical, occupational, financial, and policy information.
• Oversee claim evaluations by identifying and reconciling inconsistencies, leveraging Fraud, Waste and Abuse resources, and resolving escalated customer concerns.
• Manage communication with claimants, customers, providers, attorneys, brokers, and family members by delivering clear, timely updates on claim status and complex benefit calculations.
• Develop associate capability and claim quality by supporting onboarding, coaching, mentoring, and participating in projects that drive continuous improvement and enhance the customer experience.
• Cook up with internal and external partners, including physicians, attorneys, vocational consultants, and CPAs, to obtain and evaluate information required for thorough and defensible claim decisions.

Requirements

• 5+ years of LTD/IDI insurance claims experience.
• Demonstrated customer service skills through internal and external customer interactions.
• Experience applying independent judgment and making well-reasoned decisions based on available facts.
• Strong problem-solving and critical-thinking skills.
• Proficiency working across multiple systems and technology resources in a fast-paced environment.
• Strong organizational and time-management skills.

Preferred Qualifications

• Bachelor’s degree; and knowledge of STD/FMLA, state leave laws, workers’ compensation, ERISA.

Pay

The expected salary range for this position is $64,000 - $80,000. This role may also be eligible for annual short-term incentive compensation and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms.

Schedule

This role offers a flexible schedule to accommodate the needs of both the employee and the company.