Group Insurance Sr. Disability Claims Examiner (R-124225)

Operations - Insurance Operations

This Senior Level Claim Manager role will provide concierge-level customer service to one of Group Insurance’s largest clients. By gaining a deep understanding of the client’s culture and using expert customer service skills, the Senior Claim Manager will take a consultative approach in guiding and coaching our client’s employees through the life cycle of a disability claim. With exposure to multiple products, including Short Term Disability, Statutory Leaves, Absence, Long Term Disability, and Life Waiver of Premium, the Senior Claim Manager will deliver world-class service that ensures a more effortless experience for the employee.

As an exceptional collaborator, the Senior Claim Manager will engage Expert Resources to further enhance the claim journey, addressing Behavioral Health and Vocational opportunities within their block of claims. This Concierge Team Member will have the opportunity to interact directly with the Leave team at the client during quarterly virtual meetings and will interface daily with the client’s Benefits Business Partners.

As an innovator, the Senior Claim Manager will seek out opportunities to further enhance the claimant experience and will serve as an ambassador for continuous process improvement within the Concierge Team.

The Senior Level Claims Manager is responsible for providing excellent customer service while managing an assigned block of around 75 Long-Term Disability (LTD) and Short-Term Disability (STD) claims. The assigned claim block will fluctuate between more or fewer LTD and STD claims, depending on the team’s needs. The Senior Claims Manager will be responsible for overseeing a block of complex claims, including those with co-morbidities, behavioral health issues, and self-reported symptoms.

Qualifications:

3+ years of LTD experience is required

STD claim handling and Life Waiver of Premium experience and/or understanding is preferred

Expert-level, proactive communication skills using a variety of pathways including telephone, email, letters, Teams messaging, group Teams calls, and one-on-one video calls to deliver exceptional, white-glove service to the customer

An energetic customer focus evidenced through maintaining customer relationships

Confidence in communicating with highly skilled and highly educated claimants in the software industry

Ability to interact confidently with attorneys and specialty medical professionals such as Psychiatric providers

Excellent documentation skills to capture the essence of telephone conversations and to establish clear, concise claim plans

Ability to comprehend and interpret complex and non-standard policy and plan provisions

Strong ability to independently work through ambiguous situations and adjust course quickly when needed

Advanced math skills with the ability to perform financial calculations related to salary and incentives, partial disability calculations, RTW incentives, and offsets

Provides technical direction to other claims personnel as needed

Excellent organizational and time management skills

Demonstrated teamwork skills and ability to leverage resources to attain goals

This position will work virtually; therefore, new hires must be able to provide the following & all new hires who work remotely will be held accountable to these standards:

Subscribe to an internet service provider plan with at least 25 Mbps download speeds. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary.

Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline. Your personal phone number will not be identified to customers.

Quiet area in your home with minimal distractions and noise-free.

Reliability and dependability throughout our extensive training program are required.