Senior LTD Claims Case Manager III (NE)

The Long Term Disability (LTD) Claims Case Manager III 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, and the Clinical and Vocational Teams 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.

You Have:

• Minimum three years of Long Term Disability claims experience
• Four-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 and sound judgement in decision making
• Ability to analyze evidence for discrepancies
• Ability to conduct research using multiple techniques
• Excellent time management and organizational skills
• Multitasking with the ability to manage continually changing priorities and prioritize work based on customer service needs and departmental regulations
• Self-motivated and able to work independently
• Work collaboratively with multiple professional disciplines and diverse populations
• Basic computer skills and 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 Clinical and Vocational Teams 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 Short Term Disability team on large group claims for early interventions when claims are identified as having potential to transfer to Long Term Disability in order to reduce potential risk exposure
• Mentoring new hires, partnering with the Team Leader and Technical Consultant on team trends, areas of focus, and assist with training and development

Reporting Relationships

This position reports to the Long Term Disability Team Leader, who in turn, reports to the Long Term Disability Manager.
 

Location

Remote work flexibility

Salary Range:

$58,620.00 - $96,300.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals.  Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Comp