The Senior Claims Examiner is responsible for investigating, analyzing, and adjudicating complex long-term disability claims in accordance with policy provisions and regulations. The role also involves mentoring newer team members, managing a complex caseload, and assisting management with trend identification and executive inquiries.
Lead moderately sized Technology Operations projects supporting the Retirement Services business, delivering strategic initiatives within scope, schedule, and budget. Coordinate cross-functional teams and partners, manage risks and changes, communicate project status, and support quality delivery and adoption.
The Clinical Nurse Specialist reviews medical documentation to answer claims-related questions and coordinates independent medical examinations and peer reviews. They also serve as a medical resource for examiners, assist with department training, and participate in complex claim discussions.
The specialist manages a caseload of accommodation requests by reviewing medical documentation and facilitating the interactive process between employees and employers. They ensure compliance with ADAAA, PWFA, and other relevant legislation while maintaining strict confidentiality of health information.
The Customer Care Representative handles inbound calls from policyholders and partners to assist with claim status, policy explanations, and service inquiries. They are responsible for resolving complex issues, maintaining productivity standards, and navigating multiple systems to provide high-quality service.
The Customer Care Representative Sr. manages inbound and outbound communications to support claimants and claims examiners with disability and leave processes. They are responsible for accurate documentation, resolving routine technical issues, and maintaining claimant confidentiality in accordance with HIPAA regulations.
The specialist acts as a liaison between clients, employees, and healthcare providers to manage claims and facilitate returns to work. Responsibilities include investigating claim issues, interpreting contract provisions, and ensuring compliance with HIPAA and regulatory guidelines.
