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LTD Claims Assessor I

2 months ago

Philadelphia, Pennsylvania, United States Reliance Standard Full time
Job Overview

As a key member of our team, the LTD Claims Examiner I is responsible for evaluating and processing claims related to Long-Term Disability (LTD), Voluntary Disability, and Waiver of Premium. The primary objective of this role is to ensure accurate and fair claim determinations based on comprehensive reviews of all relevant information and adherence to policy terms.

Key Responsibilities

In this position, you will:
  • Conduct thorough investigations of disability claims through effective communication with claimants, employers, credit unions, healthcare providers, and other relevant parties to gather essential information.
  • Make informed adjudication decisions in alignment with contractual obligations, company policies, and applicable state and federal regulations, while meeting established productivity and quality benchmarks.
  • Leverage medical and risk management resources appropriately, ensuring timely transfers of claims to the correct risk levels.
  • Perform detailed investigations for pre-existing conditions or contestable claims as necessary.
  • Calculate various benefit payments, including partial disability, integration with other income sources, and survivor benefits.
  • Maintain accurate online claim records and, when necessary, physical files.
  • Deliver exceptional customer service that is respectful, timely, and precise in a fast-paced environment.
Analysis and Adjudication
  • Thoroughly investigate straightforward claims and present recommendations to senior examiners or management for review and approval.
Case Management
  • Oversee a caseload of 60-80 uncomplicated claims.
  • Collaborate with supervisors or senior examiners to enhance desk management skills and prioritize tasks to ensure all claims are processed within expected timelines.
Required Qualifications

To be successful in this role, candidates should possess:
  • A High School Diploma or GED; an Associate's degree in Business, Finance, Social Work, or Human Resources is preferred.
  • Prior experience in decision-making and information analysis, preferably within a claims or insurance environment.
  • A foundational understanding of claims administration, relevant laws, and regulations.
  • Strong organizational and prioritization skills.
  • Experience in handling confidential information.
  • Proficient mathematical and calculation abilities.
Physical Requirements

This role involves:
  • Prolonged periods of sitting, frequent standing, and walking distances up to one mile.
  • Occasional lifting of up to 25 lbs, bending, crouching, kneeling, and reaching.
  • Extensive typing and the ability to handle small objects using primarily fingers.
Core Values
  • Collaboration
  • Compassion
  • Empowerment
  • Integrity
  • Fun
What We Offer

At Reliance Standard, we are committed to fostering a diverse, equitable, and inclusive workplace. We offer a competitive compensation package along with a variety of benefits aimed at supporting our team members' financial, physical, and mental well-being.

Our Benefits Include:
  • An annual performance bonus for all employees.
  • A generous 401(k) company match with immediate vesting.
  • Three medical plan options, including prescription drug coverage, with contributions to Health Savings Accounts for High Deductible Health Plan participants.
  • Multiple dental and vision coverage options.
  • Company-provided Life & Disability Insurance for financial protection.
  • Family-friendly benefits, including Paid Parental Leave and Adoption Assistance.
  • Flexible hybrid work arrangements for eligible positions.
  • Tuition Reimbursement and Continuing Professional Education opportunities.
  • Paid Time Off, volunteer days, and an Employee Assistance Program.
  • Opportunities to connect with colleagues through Employee Resource Groups and our Diversity, Equity & Inclusion Council.
EEO Statement

Reliance Standard is an equal opportunity employer, committed to making employment decisions without regard to race, color, religion, sex, national origin, age, disability, or any other characteristic protected by law.