Senior Disability Claims Examiner

This is a fully remote position, open to applicants in Maine.

📋 Description

• Deliver concierge-level customer support to one of Group Insurance’s major clients.

• Employ a consultative approach to guide and coach client employees throughout the disability claim life cycle.

• Provide exceptional service to ensure a seamless experience for the employee.

• Engage Specialist Resources to further improve the claim journey, focusing on Behavioral Health and Vocational opportunities.

• Directly interact with the client’s Leave team during quarterly virtual meetings.

• Communicate daily with the client’s Benefits Business Partners.

• Look for opportunities to enhance the claimant experience.

• Act as an ambassador for ongoing process improvements within the Concierge Team.

• Manage a designated block of approximately 75 Long-Term Disability (LTD) and Short-Term Disability (STD) claims.

• Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health challenges, and self-reported symptoms.

⛳️ Requirements

• Minimum of 3 years of experience in LTD is required.

• Experience handling STD claims and familiarity with Life Waiver of Premium is preferred.

• Proficient, proactive communication skills using various channels including phone, email, letters, Teams messaging, group Teams calls, and one-on-one video calls to provide exceptional, white-glove service to clients.

• A strong customer focus demonstrated through the maintenance of customer relationships.

• Confidence in engaging with highly skilled and educated claimants within the software industry.

• Ability to interact confidently with attorneys and specialized medical professionals, such as Psychiatric providers.

• Excellent documentation capabilities to accurately capture the essence of phone conversations and to create clear, concise claim plans.

• Ability to understand and interpret complex and non-standard policy and plan provisions.

• Strong capability to navigate ambiguous situations independently and adapt quickly when necessary.

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

• Ability to provide technical guidance to other claims personnel as needed.

• Excellent organizational and time management abilities.

• Proven teamwork skills and the ability to leverage resources to achieve goals.

🏝️ Benefits

• Medical, dental, vision, life insurance, and disability insurance.

• Paid Time Off (PTO).

• Leave of absences, including parental and military leave.

• 401(k) plan with company match (up to 4%).

• Company-funded pension plan.

• Wellness Programs offering up to $1,600 annually for reimbursement of items that support personal wellbeing needs.

• Work/Life Resources to assist with topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.

• Education Benefit to help finance traditional college enrollment for obtaining an approved degree and numerous accredited certificate programs.

• Employee Stock Purchase Plan: Shares can be acquired at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service.