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Posted: Monday, September 4, 2017 12:41 AM

If you want to make a positive difference and stand out from the crowd, youA?ll fit in at The Standard (Our Individual Disability Insurance business line is dynamic and fast paced; and its talented and friendly employees enjoy challenge while deriving satisfaction from providing services and products that can greatly impact the people we serve. Come join us and share our passion for serving our customers in a positively different way. The Disability Claim Spec / Sr. Disability Claim Spec will secure and analyze claim information to make and approve appropriate claim and disability management strategies to ensure prompt and accurate disability decisions and payments on complex, high liability or more problematic types of disability claims. Provide responsive customer service to claimants (policyholders), employers, group offices and agents. Serve as a technical resource and section leader.Contribute to the companyA?s success through excellent customer service and meeting or exceeding performance objectives for the following major job functions: Develop a claim and management strategy for each claim to appropriately determine claim eligibility, contain claim liability and provide excellent customer service. On an ongoing basis investigate, secure and analyze information pertaining to claimants medical condition, occupational demands, work earnings, business income and expenses, insured status, including whether coverage is contestable,and other policy provisions to accurately determine eligiblity for and entitlement to disability benefits within prescribed timeframes and accurate payment of benefits; Identify financial, occupational or medical discrepancies and outstanding issues and secure necessary documentation. Identify possible fraud and work closely with the SIU on investigation and evaluation. Make and communicate disability approval or adverse decisions, communicating with sensitivity to tone and content. Respond to complex/sensitive claim and account inquiries from claimants, attorneys, claimant financial advisors, policyholders, field personnel, and other interested parties; resolve related issues through effective oral and written communication, and by involving the appropriate people within, or outside, the department or company. Act as a client contact within the department, unit and enterprise, working in partnership with Benefits, Underwriting, Sales, Legal and SIU. Demonstrate leadership ability and skill, at times conducting review and approval of claim decisions, disability management strategies and payments recommended by less:seasoned staff; develop medical, occupational, financial and/or investigative expertise of benefit to the section and department; participate in formal and informal training for the department, section and individuals; sharing knowledge and expertise with team. Ensure the companys reserve liability is accurately established by identifying all applicable claim offsets and maintaining accurate claim and system data. Identify reinsured claims and seek appropriate reimbursement of expenses. Demonstrated skills: Provide appropriate and timely disability, claim, and account management and administration for complex claims. Recognize, understand and respond to complex claim and account inquiries from all interested parties in a disability claim. . Recognize, understand, and respond to situations involving potentially fraudulent activity and/or litigation, working in partnership with SIU aand Legal department as appropriate. Ability to: Understand and interpret claim evaluation material, including contract language, medical records, occupational and financial records, and legal correspondence. Develop expertise in one or several areas of benefit to the section and department. Provide effective coaching and training of others. Make decisions in the absence of specific direction. Effectively identify and prioritize critical objectives focusing on high impact components. Working knowledge of: Con

Source: https://www.tiptopjob.com/jobs/71610495_job.asp?source=backpage


• Location: portland

• Post ID: 22806587 portland
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