Long Term Disability Claims Case Manager I

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.
 

The LTD Claims Case Manager can be located in multiple locations including Bethlehem, PA; Plano, TX; Holmdel, NJ or remote.

You will
 

This position 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. This position partners with coworkers to broaden and enhance their knowledge of complex claim handling.

The LTD Claims Case Manager administers claims within a variety of group sizes ranging from small
(2+ lives) to large market (1000+ lives). This position is responsible for determining integrated income to ensure appropriate financial risk and accurate payments are made. The LTD Claims Case Manager is responsible for ensuring all plan provisions are met through the duration of the claim. The LTD Claims Case Manager consults with legal, investigative resources, and financial specialists.

A selected incumbent may be assigned to the Stable and Mature block as well.

You have

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

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
   

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
   

Partnering

• Consult with the Professional Resource Team area to assess functionality and return to work potential by utilizing available resources
• Perform and complete timely change in definition investigations by utilizing the Professional Resource Team and outside vendor assistance
• Partner with the Short Term Disability team on …