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- Manages assigned caseload of more complex disability cases.
- Evaluates claimant eligibility.
- Utilizes specialty consulting resources effectively including medical, legal, vocational and/or rehabilitative staffs to achieve optimum outcomes for claims direction.
- Interacts with internal and external customers including, but not limited to, claimants, employers, physicians, attorneys and underwriters to gather the information to make the decision on the claim.
- Analyzes, approves or denies Disability Income and Waiver of Premium claims for contestable and non-contestable cases.
- Provides technical direction to other claims personnel as needed.
- Decides payment period, follows up and monitors payment accuracy and timeliness; follows plan to closure.
- Incumbents typically have 3-5 years of relevant experience.
- Typically reports to Supervisor of Disability Claims.
- Ability to manage multiple and changing priorities
- Excellent organizational and time management skills
- Strong written and communication skills demonstrated in previous work experience
- Specific experience with collaborative negotiations
- Proven skills in positive and effective interaction with challenging customers
- Experience in effectively meeting/exceeding individual professional expectations and team goals.
- Demonstrated analytical and math skills
- Ability to exercise sound judgment
- High level of flexibility to adapt to the needs of the organizations
- PC skills preferred (i.e. Windows based environment)
- College degree and prior claim experience required