Group Claims Specialist

 

The Group Claims Specialist is responsible for evaluating and assessing eligibility of Long Term Disability and Short Term Disability applications and evaluating and processing Life claims in our Madison, Wi office.
This is a remote position!
Duties and Responsibilities:

• Evaluate long-term and short-term disability applications using the managed disability claim process.
• Evaluate and process Life claims.

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• Perform direct telephonic interviews with applicants and with the medical providers of service.
• Document conversations held with claimants, medical providers, employers or persons acting on insured's behalf after each interaction according to procedures.
• Demonstrate responsive, knowledgeable, and courteous service in all customer interactions with both internal and external customers.
• Complete detailed SOAP (Subjective, Objective, Assessment and Plan) procedures on each initial application received. Continue ongoing claim management with continued assessment and plan portion of SOAP notes documented in file.
• Enter accurate claim information in computer system to ensure correct claim payment amount, correct benefit dates and document dates for future claim reviews.
• Maintain proper claim file organization in chronological order and according to internal guidelines
• Develop appropriate claim strategy for each approved claim including use of medical and vocational vendors of service when appropriate.
• Investigate other income sources insured's may be entitled to through Social Security, Workers Compensation and State Pension plans or other entities.
• Calculate and recover claim overpayments as a result of other income sources consistent with group department guidelines.
• Initiate transition of claim review six months prior to the own occupation/any occupation phase.
• Mentor newer claims specialists.

Job Requirements:

• Bachelor's Degree preferred with at least two years of experience
• Required High School Degree with at least four years of experience
• Regular and reliable attendance is required.
• Candidate must possess excellent communication skills including the ability to convey routine and complex information to all external contacts in a clear, concise, and persuasive manner.
• Thorough understanding of short and long-term disability concepts and related benefit information.
• Effective listening skills and must appropriately respond to questions asked in a clear and concise manner.
• Ability to exercise superior judgment with regard to confidential information required along with high level math skills.
• Working knowledge of Microsoft Word, Excel and Outlook.
• Familiarity with claims operating systems.

Work location is flexible if approved by the Company except that the position may not be performed remotely from NYC.
#VIZI#
Horace Mann was founded in 1945 by two Springfield, Illinois, teachers who saw a need for quality, affordable auto insurance for teachers. Since then, we've broadened our mission to helping all educators protect what they have today and prepare for a successful tomorrow. And with our broadened mission has come corporate growth: We serve more than 4,100 school districts nationwide, we're publicly traded on the New York Stock Exchange (symbol: HMN) and we have more than $12 billion in assets.
We're motivated by the fact that educators take care of our children's future, and we believe they deserve someone to look after theirs. We help educators identify their financial goals and develop plans to achieve them. This includes insurance to protect what they have today and financial products to help them prepare for their future. Our tailored offerings include special rates and benefits for educators.
EOE/Minorities/Females/Veterans/Disabled. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status
For applicants that are California residents, please review our California Consumer Privacy Notice
All applicants should review our Horace Mann Privacy Policy

Job Type: Full-time

Pay: From $45,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Supplemental pay types:

• Bonus pay

Work Location: Remote

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