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:

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 Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact MyHR@glic.com. Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian, refer to the Guardian Careers site.

Visa Sponsorship

Guardian is not currently or in the foreseeable future sponsoring employment visas. In order to be a successful applicant. you must be legally authorized to work in the United States, without the need for employer sponsorship.

Notice Regarding Guardian’s Use of Artificial Intelligence in Recruitment

As part of Guardian’s job application process, Guardian may use artificial intelligence tools (“AI Tools") to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying, as specified in the listing posted on Guardian’s jobs website (Careers at Guardian at https://www.guardianlife.com/careers). At Guardian, we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues.

Please be aware that if you apply for a specific position with Guardian, you will have the choice of opting out of Guardian’s use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation, within ten business days of your position application, you must email your request to MyHR@glic.com, making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardian’s document retention policy, a copy of which you may request via MyHR@glic.com.

Additionally, at applicable times, Guardian will make public the most recent bias audit results for such AI tools, which may be found here. 

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.