LTD Claims Examiner I job – Reliance Standard Life Insurance Company – Philadelphia, PA

LTD Claims Examiner I

Reliance Standard Life Insurance Company

9 reviews


Philadelphia, PA

The LTD Claims Examiner I obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and WOP claims. Develop and apply appropriate claim and disability management techniques to ensure prompt and accurate payment decisions and management of disability claims. Provides responsive customer service to claimants, policyholders, brokers and internal departments.

Duties and Responsibilities :

  • Prompt and thorough investigation of claims within departmental and regulatory guidelines.
  • Interprets and administers contract provisions including, but not limited to, eligibility, covered monthly earnings, definition of Total Disability, verification of applicable offsets and pre-existing investigations.
  • Develops, implements and modifies disability management plan to establish strategy and manage outcome.
  • Documents claim file actions and telephone conversations appropriately.
  • Refers claim activity outside authority level to Supervisor/Manager for review.
  • Pro-actively communicates with claimants, policyholders, and physicians to resolve investigations issues.
  • Establishes, communicates and manages claimant and policyholder expectations.
  • Utilizes most efficient means to obtain claim information.
  • Fully investigates all relevant claim issues, provides payment or denials promptly and in full compliance with departmental procedures and Unfair Claims Practice regulations.
  • Responds to customer service issues within required timeframes.
  • Refers claims above authority to a supervisor/manager.
  • Demonstrates ability to independently handle claims not of a complex nature.
  • Involves technical resources (Social Security Specialist, medical resources, vocational resources) at appropriate claim junctures.
  • Supports relationships with technical resources to achieve appropriate outcomes.
  • Meets or exceeds departmental service, quality and production objectives
  • Collaborates with team members and management in identifying and implementing improvement opportunities.
  • All other duties as assigned.

Education, Qualifications and Experience :

  • Bachelor’s degree preferred.
  • 0-2 years disability claim management experience.
  • Experience with computer applications – Word, Excel desired.
  • Work experience in decision-making and information analysis.
  • Demonstrated prioritization and organization skills.
  • Ability to meet deadlines while balancing competing demands.
  • Good math and calculation skills.

9 reviews

Employers of all sizes can rely on Reliance Standard for insurance and other benefits products. Reliance Standard Life Insurance, a…

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A Computer Programmer whose articles got mentions from the likes of The New York Times, Kissmetrics and AllTopStories. He writes articles, novels and poems; spends most of his time reading everything he could get his hands on. He is currently pursuing his Masters from The University of Illinois and holds a Bachelors in Electronics Engineering from the University of California. He is a programmer, a motivational writer and speaker.

One comment

  1. Hire people that understand what integrity means

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