Benefit Claim Specialist -STD

As a vital member of our Claim Disability teams, you will be responsible for making informed decisions throughout the life of insurance claims, from initial adjudication to ongoing claims management. Working in collaboration with management, you will leverage claim facts and conduct thorough evaluations, gathering pertinent information to formulate appropriate action plans.

WHAT WE CAN OFFER YOU:

• Benefit Claim Specialist $26.00 - $27.00, plus annual bonus opportunity.
• Sr Benefit Claim Specialist: $56,000 - $70,000, plus annual bonus opportunity.
• Lead Benefit Claim Specialist: $59,500 - $76,000, plus annual bonus opportunity.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time and paid holidays. See our benefits and perks page for details.
• Applicants for this position must not now, nor at any point in the future, require sponsorship for employment.

WHAT YOU'LL DO:

• Make decisions in partnership with management based on a comprehensive understanding of claim facts and thorough evaluation of relevant information.
• Develop case files that showcase sound decision-making in accordance with documented procedures, using claim facts, policy provisions, and special handling agreements. Foster effective business relationships through clear communication with claimants, brokers, sales organizations, vendor partners, employers, and internal departments such as underwriting and legal.
• Thoroughly document all claim decisions and actions meticulously, maintaining regular and appropriate communication. 50% of your day will be on the phone with claimants, employers, and medical professionals throughout the entire claims life cycle.
• Review and determine ongoing claim liability, involving the evaluation of claim documentation, resolution of queries, and identification of any changes in claim status or benefits. Collaborate with internal and external partners, including brokers, sales organizations, clinical and physician resources, vocational experts, and financial resources.
• Accurately determine financial liability by analyzing salary, other income sources, medical/vocational information, and contract language. Exercise limited autonomy to approve initial and ongoing payments based on a holistic file evaluation.

WHAT YOU’LL BRING:

• 3 + years of current Short Term Disability Claims Processing experience.
• Demonstrate a foundational ability to analyze, comprehend and apply insurance provisions and contracts to disability claims.
• Ability to calculate disability benefits based on contract provisions and offset management to provide fair, equitable and consistent treatment of claims necessary for accurate financial payments and policyholder retention and satisfaction.
• Proficient with navigating multiple systems and Microsoft Office Suite
• Provide a solid level of customer service (written and verbal) while displaying empathy to customers.
• You promote a collaborative culture, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• After training you are able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

We value unique 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 . Please allow at least one week from time of applying if you are checking on the status.

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