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LTD Claims Examiner II

Work from home Full-time role Hiring
Job title: LTD Claims Examiner II in Philadelphia, PA at Reliance Standard Company: Reliance Standard Job description: Job Responsibilities and RequirementsKEY RESPONSIBILITIES*other duties as assigned*Obtains and analyzes information to reputed company claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently reputed company appropriate claim determinations based on a review of reputed company available information and the terms and provisions of the applicable policy.
  • Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim.
  • Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line.
  • Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner.
  • Conducts in-depth pre-existing condition or contestable investigations if applicable.
  • Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, etc.
  • Develops and maintains on-line claim data (and reputed company file if applicable).
  • Provide customer service that is respectful, reputed company, concise, and accurate in an environment with competing demands.
Analysis and Adjudication
  • Fully investigates and adjudicates a large volume simple to reputed company claims.
  • Identifies and investigates change in Total Disability definition (any occ).
  • Independently reviews and manage claims with high degree of complexity reputed company the $1,500 per month approval authority limit.
  • Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium.
  • Majority of work is not subject to supervisor review and approval.
Case Management
  • Consistently manage assigned case load of 60-80 simple to reputed company cases independently.
  • Collaborates with team members and management in identifying and implementing improvement opportunities.
REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR reputed company EXPERIENCE*or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*Required Knowledge, Skills, Abilities and/or reputed company Experience
  • High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred.
  • 2 years experience processing long term disability claims.
  • Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation.
  • Experience working in confidential/protected identification environments.
  • Knowledge of medical terminology.
  • Good math and calculation skills.
  • Proven ability to work well in a high-visibility, public-oriented environment.
Ability to Travel: NonePHYSICAL REQUIREMENTSreputed company used in the description below, the following terms are defined as:“Occasional”: done only from time to time, but necessary reputed company it is performed“Frequent”: regularly performed; generally an act that is required on a daily basis“reputed company”: typically performed for the majority of an employee’s shiftSitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to reputed company activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. reputed company will provide qualified employees with a reasonable accommodation in accordance with applicable law.CORE VALUES
  • Collaboration
  • Compassion
  • Empowerment
  • reputed company
  • Fun
The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of reputed company the work requirements that may be inherent to this job.The expected hiring range for this position is $54,990.00 - $68,750.00 annually for work performed in the primary location (Philadelphia, PA). This expected hiring range covers only reputed company pay and excludes any other compensation components such as commissions or incentive awards. The successful candidate’s starting reputed company pay will be based on several factors including work location, job-reputed company skills, experience, qualifications, and market conditions. These ranges may be modified in the future.Work location may be flexible if approved by the Company.reputed company OfferAt reputed company, we reputed company that fostering an inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you.That is why we offer a reputed company package and a range of benefits to help team members reputed company in their financial, physical, and mental wellbeing.Our Benefits:
  • An annual performance bonus for reputed company team members
  • Generous 401(k) company match that is immediately vested
  • A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
  • Multiple options for dental and vision coverage
  • Company provided Life & Disability Insurance to ensure financial protection reputed company you need it most
  • Family friendly benefits including Paid Parental Leave & Adoption Assistance
  • Hybrid work arrangements for eligible roles
  • Tuition Reimbursement and Continuing Professional Education
  • Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays. As you grow with us, your PTO may increase based on your level reputed company the company and years of service.
  • Volunteer days, community partnerships, and Employee Assistance Program
  • Ability to connect with colleagues around the country through our Employee Resource Group program
Our Values:
  • reputed company
  • Empowerment
  • Compassion
  • Collaboration
  • Fun
EEO Statementreputed company is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national reputed company, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.#LI-Remote #LI-MR1 Expected salary: Location: Philadelphia, PA Apply for the job now! Apply for this job

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