Benefit Claim Specialist (STD & LTD) - Remote
About the position
As a vital member of our Short and Long Term Disability teams, you will be responsible for making informed decisions throughout the life of insurance claims, from initial adjudication to ongoing claims management. This role requires a keen understanding of the claims process and the ability to analyze complex information to ensure fair and accurate outcomes for our clients. You will work closely with management to leverage claim facts and conduct thorough evaluations, gathering pertinent information to formulate appropriate action plans. Your expertise will be crucial in navigating the intricacies of each claim, ensuring compliance with company policies and regulatory requirements while maintaining a high level of customer service. In this position, you will be expected to manage a caseload of disability claims, reviewing medical documentation, and collaborating with healthcare providers to assess the validity of claims. You will also be responsible for communicating with claimants, providing updates on their claims status, and addressing any questions or concerns they may have. Your ability to interpret medical information and apply it to the claims process will be essential in making sound decisions that impact the lives of our clients. Additionally, you will participate in team meetings and training sessions to stay updated on industry trends and best practices. Your contributions will help shape the direction of our claims management strategies, ensuring that we continue to provide exceptional service to our clients while adhering to all regulatory standards.
Responsibilities
Make informed decisions throughout the life of insurance claims.
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Conduct initial adjudication and ongoing claims management.
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Collaborate with management to leverage claim facts.
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Gather pertinent information to formulate appropriate action plans.
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Review medical documentation and assess the validity of claims.
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Communicate with claimants regarding their claims status and address inquiries.
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Participate in team meetings and training sessions to stay updated on industry trends.
Requirements
Strong understanding of the insurance claims process.
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Ability to analyze complex information and make informed decisions.
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Excellent communication skills, both verbal and written.
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Experience in reviewing medical documentation and collaborating with healthcare providers.
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Detail-oriented with strong organizational skills.
Nice-to-haves
Experience in disability claims management.
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Knowledge of regulatory requirements related to insurance claims.
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Familiarity with customer service best practices.
Benefits
Health insurance coverage.
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401k retirement savings plan.
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Paid time off and holidays.
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