STD Claims Appeals Specialist

Job not on LinkedIn

🔥 46 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $74.8k - $78.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Lincoln Financial

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1905

💼 Consulting

⚖️ Legal

💸 Finance

Consulting • Legal • Finance

Lincoln Financial is an organization dedicated to protecting the privacy and security of its job applicants. It actively informs candidates about potential recruitment scams and outlines its robust hiring procedures, making clear that they do not request sensitive personal information during the application process. The company offers a diverse range of career opportunities across various fields including actuarial, finance, legal, and customer service, and is committed to maintaining equal employment opportunities.

📋 Description

• Analyze & process claims by investigating & obtaining a wide range of complex information • Apply claim policies & procedures and engages intervention of internal/external resources to ensure fair, ethical, & timely management of assigned claims • Analyze and interpret complex coverage contracts to determine if eligibility is met • Identify and resolve gaps in financial calculations and offsets when applicable, share technical knowledge and approach on financial calculations with team members • Interpret calculations correctly involving complex contract provisions and work with applicable resources as needed to resolve issues • Research questions and escalations from Claims team; liaises with various stakeholders from across the business (Underwriting, Actuarial, Compliance, Account Management, etc.) to obtain needed information to clarify and address issues • Provide customers with in-depth explanations of policy details, claim process, and claim determination; ensure parties understand the information and outcome • Utilize internal reporting to identify trends and review/audit performance against team metrics; propose and develop practices & processes to improve performance and the customer experience • Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims workflow • Provide detailed guidance & coaching to junior team members

🎯 Requirements

• 4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's) • 3+ years of claims and/or appeals experience with LTD/STD claims • Ability to communicate effectively (verbal/written) • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

🏖️ Benefits

• PTO/parental leave • Competitive 401K and employee benefits • Free financial counseling, health coaching and employee assistance program • Tuition assistance program • Working arrangements that work for you • Effective productivity/technology tools and training