As the Disability Appeals Specialist, you will be responsible for the risk management of appeals/complaints for the disability departments.
- Manage the risk appeals/complaints for disability departments.
- Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Track all decisions, backlog, and pending files.
- Review settled insurance claims to determine if processed in accordance with company practices and procedures.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Contact and/or interview claimants, doctors, medical specialists, or employers to get additional information.
- Confer with legal counsel on claims requiring litigation.
- Present cases to the Appeals Council presenting and participating in active discussion. Accountable for responding to Presidential and/or Insurance Department complaints.
- Undergraduate degree or 4+ years of comparable work experience
- Education experience and/or proficiency in disability claims and medical terminology required
- 1-3 years of experience in disability claims that directly aligns with the specific responsibilities for this position.
- A demonstrated track record of consistently meeting and/or exceeding performance expectations.
- Possesses a bias for action and avoids workplace distractions; drives performance targets to completion.
Lincoln Financial Group - 2 years ago
Lincoln Financial Group is a diversified financial services organization headquartered in the Philadelphia region. With $150 billion as of...