Process Associate

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

The Case Specialist I, STD is supporting Group Short Term disability. We have a service and fiscal responsibility to our Policyholders and Plan Members.For our Policyholders and Plan Members, this means we are managing their claims efficiently and effectively using sound practices aligned with our philosophy and approach to disability management.We provide superior claim management using due diligence and sound claims practices. Our fiscal responsibility extends to our company for both earnings and regulatory compliance.We are accountable for protecting and nurturing our reputation, which includes our image both externally and internally.

What you will do:

• Utilizes standard guidelines to make claim decisions
• Verifies accuracy of information received as it applies to the plan and calculates, approves, or denies proper benefit amount according to plan and contract details
• Demonstrates the ability to effectively utilize resources in the department and understands how each resource can help them to achieve results given the particulars of the claim
• Consults with a team leader or manager to discuss claims and strategy but can make the correct claim determination independently on simple claims
• Can anticipate and manage caseload effectively and all the competing demands that accompany it
• Calls upon knowledge of medical conditions, diagnoses and treatments and uses it to analyze current claims
• Can communicate effectively with claimants, policyholders, sales representatives, and internal colleagues
• Manages the claimant's expectations throughout the claim process
• Has the ability to understand how their daily activities/tasks fit into the business plan and strategy
• Can identify the issues in a claim that warrant further review and exploration

What you will need to succeed:

• Excellent verbal & written communication skills
• Broad grasp of claim practices
• Has the ability to look at the big picture
• Ability to select action from a variety of established routines that are guided by the incumbent's judgement, as situations vary
• Communicates effectively, providing understanding in a conflict situation

Job Category:

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