Long Term Disability Claims Case Manager I

About the role

The Long Term Disability (LTD) Claims Case Manager is responsible for making accurate decisions on assigned claims through proactive case management according to the plan provisions, state and federal guidelines, and established protocols. This position consults with other team members, as well as, the Professional Resource Team to assist claimants with return to work efforts when the capability and opportunity exist.

Responsibilities

• Utilizes problem solving, analytical, written and verbal communication skills to deliver timely and appropriate disability claim decisions while providing superior customer service to all internal and external customers.
• Partners with coworkers to broaden and enhance their knowledge of complex claim handling.
• Administers claims within a variety of group sizes ranging from small (2+ lives) to large market (1000+ lives).
• Determines integrated income to ensure appropriate financial risk and accurate payments are made.
• Ensures all plan provisions are met through the duration of the claim.
• Consults with legal, investigative resources, and financial specialists.
• May be assigned to the Stable and Mature block.
• Conducts change in definition investigations by utilizing the Professional Resource Team and outside vendor assistance.
• Partners with the Short Term Disability team on large group claims for early interventions when claims are identified as having potential to transition to Long Term Disability in order to reduce potential risk exposure.

Requirements

• Four-year college degree preferred or equivalent work/education experience
• Regulatory and Compliance experience a plus

Qualifications

• Functional Skills: Excellent written and verbal communication skills, Ability to exercise independent & sound judgment in decision making, Ability to analyze evidence for discrepancies, Ability to conduct research using multiple techniques, Excellent time management & organizational skills, Multitasking with the ability to manage continually changing priorities and ability to prioritize work based on customer service needs and departmental regulations, Self-motivated & able to work independently, Ability to work collaboratively with multiple professional disciplines and with diverse populations, Basic computer skills & knowledge, including Microsoft office, Understanding of medical terminology and medical conditions helpful

Skills

• Leadership Behaviors: Continuously strives to provide superior products and customer service, Expresses oneself in an open and honest manner, Demonstrates self-awareness and embraces feedback

Benefits

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Pay

$41,880.00 - $62,820.00

Schedule

This position can be located in multiple locations including Bethlehem, PA; Plano, TX; Holmdel, NJ or remote.