The Long Term Disability (LTD) Claims Case Manager 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, as well as, the Professional Resource Team to assist claimants with return to work efforts when the capability and opportunity exist.
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.
This position reports to the Long Term Disability Team Leader, who in turn, reports to the Long Term Disability Manager.
• Excellent written and verbal communication skills
• Ability to exercise independent & sound judgment in decision making
• Ability to analyze evidence for discrepancies
• Ability to conduct research using multiple techniques
• Excellent time management & organizational skills
• Multitasking with the ability to manage continually changing priorities and ability to prioritize work based on customer service needs and departmental regulations
• Self-motivated & able to work independently
• Ability to work collaboratively with multiple professional disciplines and with diverse populations
• Basic computer skills & knowledge, including Microsoft office
• Understanding of medical terminology and medical conditions helpful
• Continuously strives to provide superior products and customer service
• Expresses oneself in an open and honest manner
• Demonstrates self-awareness and embraces feedback
• Consult with the Professional Resource Team 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 the Short Term Disability team on large group claims for early interventions when claims are identified as having potential to transition to Long Term Disability in order to reduce potential risk exposure
• 4 year college degree preferred or equivalent work/education experience
• Regulatory and Compliance experience a plus
• 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
• Meaningful and challenging work opportunities to accelerate technology and innovation in a secure and compliant way
• Competitive compensation
• Excellent medical, dental, supplemental health, life and vision coverage for you and your dependents with no wait period
• Life and disability insurance
• A great 401(k) with match
• Tuition assistance, paid parental leave and backup family care
• Dynamic, modern work environments that promote collaboration and creativity
• Flexible time off, dress code, and work location policies to balance your work and life in the ways that suit you best
• Social responsibility in all aspects of our work. We volunteer within our local communities, create educational alliances with colleges, drive a variety of initiatives in sustainability, and advocate for diversity and inclusion in all that we do.