Case Manager LTD

Summary

Make timely, accurate, and customer-focused Long-Term Disability claim decisions. Proactively reach out to clinical, vocational, employer, financial, and other informational internal and external sources to gather relevant data, compare it to the applicable contract and procedural documents, conduct an analysis, and engage peers and management as appropriate. Communicate verbally and in writing and fully leverage the claim system with accurate and comprehensive information. Maintain performance at or above departmental metrics. Be nimble and agile. LTD claim decisions managed by this position can be quite complex and because these claims can have an elongated duration and the dollar amounts exponentially impact what is due, the risk exposure to the corporation can be substantial. Develops solutions requiring analysis and research or takes a new perspective using existing solutions. The level of independent judgement assigned to this position increases over time.

Responsibilities

✔ Make timely, accurate, and customer-focused LTD new and ongoing claim decisions. Reach out to obtain relevant clinical, vocational, employer, financial, and other information. Compare the information to the terms, limitations, and conditions of the contract and applicable procedural documents and render the claim decision as quickly as possible. Document the claim systems in an accurate and comprehensive manner while maintaining maximum levels of efficiency. Prepare and disseminate articulate written and verbal communication to assorted internal and external sources. Prepare, update, and utilize a claim management plan to attain the most appropriate outcome. Remain in full compliance with regulatory requirements. Demonstrate an above average level of proficiency in LTD product and claim administration techniques. Remain fully compliant with operational standards. Meet or exceed claim team operational metrics.
60%

✔ Maintain a superior level of genuine caring and empathetic customer service throughout all interactions. Take appropriate actions to earn the claimant’s and employer’s trust and confidence. Anticipate customer needs and take action.
20%

✔ Work as a team to support one another through flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating a dedication to excellence.
20%

Skills