Leaves Benefits Coordinator - Short-term disability

The Role

As an Insurance Claims Associate Analayst you will have the overall responsibility for processing short-term disability claims in an ethical manner, ensuring quality decisions, accurate time calculations, and proactive communication with claimants and employers. You will have the responsibility to facilitate the timely transfer of long-term disability claims, without interruption or delay in decision time. You will be expected to deliver a very high level of consultative customer service. This position is in a fast-paced, high volume environment with set production goals and requires extensive or prolonged typing/keyboarding.

Functional Responsibilities

Claims

• Processes assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality/production standards.
• Reviews and provides specific information to questions/concerns from internal/external stakeholders (e. g. internal partners, policyholders, brokers, etc.) by applying core knowledge obtained for the role.
• Reviews submitted claim information for payment.
• Ensures the accuracy and completeness of submitted claims.
• Must be able to meet predetermined productivity and quality standards.

Decision Making

• Applies core knowledge obtained for the role to effectively communicates verbally and in written form with internal/external stakeholders to obtain needed information while maintaining a professional demeanor in all interactions.
• Escalates claims issues or concerns to senior team members and/or management.
• Recognizes general issues/concerns for assigned area(s), explains effect on the customer's service experience, and suggests process improvements.

Customer Service

• Communicates with claimants, policyholders, attorneys, physicians and brokers directly either orally or written.
• Resolves claim-specific issues while maintaining internal and external customer satisfaction.
• Provides customer service to internal and/or external stakeholders, recognizes what needs to be done to meet customer needs and demonstrates flexibility and responsiveness to meet customer needs on routine work independently.

Education

• High School Diploma or GED an Associate s Degree or above, 0-1 year of claims experience that directly aligns with the specific responsibilities for this position.

Experience

• 0-1 yrs of claims experience that directly aligns with the specific responsibilities for this position
• Experience with the application of policies, practices, and procedures in a fast paced business environment strongly preferred
• 0-1 yrs of insurance policy contracts experience highly preferred
• Proven experience in a production environment
• Must have strong organizational skills, attention to detail with a high degree of accuracy, and the ability to work somewhat independently.
• Proficiency with Microsoft Office Suite including personal computer operation with skills in various software applications such as word processing, spreadsheets, electronic mail, and presentation.
• Ability to maintain regular and predictable attendance in adherence to department and company attendance expectations.
• A demonstrated track record of consistently meeting and/or exceeding performance expectations
• Possesses a bias for action and avoids workplace distractions
• Drives performance targets to completion