Disability and Leave Management Claims Specialist
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Job Description
Claims Specialist managing Disability and Leave Management claims remotely for Equitable. Providing excellent customer service while assessing risk and making claim decisions.
Responsibilities:
- Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved
- Communication via telephone, email, and text with employees, employers, attorneys, and others
- Review and interpret medical records, utilizing resources as appropriate
- Complete financial calculations
- Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication
- Apply contract/policy provisions to ensure accurate eligibility and liability decisions
- Demonstrate and apply analytical and critical thinking skills
- Verify on-going liability and develop strategies for return-to-work opportunities as appropriate
- Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication
- Leverage a broad spectrum of resources, materials, and tools to render claims decisions
- Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards
- Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities
- Work independently as well as within a team structure
Requirements:
- Bachelor’s degree or equivalent work experience
- 1+ years disability claims experience
- Exceptional customer service skills
- Maintains positive and effective interaction with challenging customers
- Strong knowledge of disability and leave laws and regulations
- Ability to handle sensitive information with confidentiality and professionalism
Benefits:
- medical
- dental
- vision
- 401(k) plan
- paid time off
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