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Please forward posts to LaShawn Maloy at firstname.lastname@example.org.
Location: Bloomfield, CT
Job Title: MetLife LTD Claims Specialist- JO# 83746
Independently assess, analyze and render appropriate claim decisions pursuant to certificates. Clarify functional capacity through independent problem solving measures and discretion (gathering medical, vocational, and other information, efficient use of resources, and action planning) sufficient to determine initial and ongoing liability. Adhere to federal and state law to maintain appropriate and timely claim outcomes. Communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis for payment/non-payment. Communicate with a variety of constituents (for example, claimants, doctors, nurses, employers, and attorneys) to gather information relevant to assessing, analyzing and rendering decisions based on the provisions of the policy and their own discretion, with limited guidance by supervisory personnel. Articulate and document their rationale for claim direction, possess the autonomy to take steps outside of CMG guidelines to the extent supported by documented rationale and the facts of the claim file. Utilize tools independently and accurately to identify work to be completed across the entire claim block, prioritize work, determine if/when to involve specialty resources such as clinical staff to obtain additional information on a claim. As the sole owner of the LTD claim, determine return to work potential and strategy, identify a likely claim progression based on the facts of the claim and take action on their own assessment of the claim.
Perform other duties as required.
Key Competencies, Qualifications and Skills, Preferred:
Bachelor’s degree preferred.Strong communication skills, both written and oral. Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning. Strong problem solving and analytical skills. Ability to work independently. Comfortable working with multiple priorities in a changing environment.
Ability to prioritize and maintain quality.
Julie Maclin, Recruiter for MetLife
Application Link: http://jobs.metlife.com/hartford/insurance-claims/jobid7013026-ltd-claims-specialist-jobs
Company: Boston Mutual Life Insurance Company
Location: Canton, MA
Job Title: Senior Claims Examiner
Boston Mutual Life Insurance Company was founded in 1891 and has been a stable financially strong company for over 120 years. Boston Mutual is proud to promote our corporate principles of Service, Value, and Integrity. As well as being a financially strong and reputable company to do business with, Boston Mutual offers its employees a wide array of competitive benefits to full time employees. These include Health, Dental, Life and Long Term Disability Insurance, generous paid vacation time, free parking, paid holidays, 401K program, Flex Spending, tuition reimbursement, and an employee assistance program as well as offering flexible work schedules.
This position is an important role geared towards a self motivated professional. We seek a high energy, detail oriented individual who is willing to take on various tasks. A self-starter who is able to work independently will thrive in this role.
Review and Process life claims and request additional information when needed.
Answer telephone inquiries concerning claim status, claim filing etc.
Read and evaluate policy/contract provisions
Review pending claims on a monthly basis
Be aware of compliance issues
Read medical records
Perform other duties as required
Minimum of 2 years college or related experience
2 years of life claims experience required
Strong PC skills- Excel, Access, Word, Internet
Strong analytical skills
Manage a variety and high volume of work
Must have strong organizational skills and be detail oriented
Knowledge of ALIS system a plus
Must have ability to make sound decisions
Insurance knowledge preferred; LOMA courses helpful
Medical Terminology a plus
Ability to work well with co-workers
Excellent attendance is required
Compliance with privacy guidelines; respecting the privacy of customer information
High level of communications skills, oral and written
To apply for this position, please send your resume to Kathy Welch at Kathy_Welch@bostonmutual.com
Company: Federated Insurance
Location: Owatonna, MN
Job Title: Life & Disability Income Claims Specialist
Federated Insurance is looking for a Life and Disability Income Claims Specialist who will process life and disability income claims by investigating, evaluating, negotiating, and resolving the claims promptly and equitably.
We are seeking an individual who is self-directed and demonstrates strong analytical abilities and attention to detail, excellent written and verbal communications, ability to multi-task and prioritize, effectively handles conflict resolution and makes sound decisions.
Asses validity of coverage
Conducts thorough investigations of the claim and evaluates findings
Establishes and retains services of external attorneys, investigators, medical directors, vendors when necessary to secure all relevant facts for proper evaluation of claims
Negotiates payments directly with the insured and/or their legal counsel
This position requires:
A four-year college degree or equivalent experience (i.e. Insurance Claims handling, Life and DI product knowledge, and/or medical knowledge and terminology)
Strong computer knowledge, proficient in Microsoft Word and Outlook
An unquestionable ability to retain confidential business and personnel information
For consideration, please send your confidential resume and salary history to email@example.com.
All postings will remain for 60 days unless otherwise noted
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