The Hartford Senior Long-Term Disability Benefit Manager in SOUTH PORTLAND, Maine
Title: Senior Long-Term Disability Benefit Manager
Location: United States-Maine-South Portland
Other Locations: United States-Oregon-Portland
Job Number: 1801200
The role of a Disability Manager is to manage Long Term Disability Benefits (LTD) to ensure prompt and accurate payment and liability management of moderately complex disability claims.
Independently reviews and interprets long term disability plan provisions and/or documents to determine claim liability.
Independently manages risk and resources on moderately complex claims.
Develops, implements and revises comprehensive disability benefit management strategy based on factors such as claimant’s medical condition, vocational options, applicable policy provisions and limitations, actual or potential offsets, etc.
Determines appropriate utilization of resources such as clinical, vocational rehabilitation, behavioral health, peer to peer review, referral to Complex Claim Investigation, social security vendors, etc.
Works with claimants, treatment providers including physicians and therapists, policyholders, and/or attorneys to update claim management strategy as appropriate.
Works with attorneys and insurance carriers regarding 3rd party litigation and/or subrogation issues.
Effectively utilizes risk management tools to determine appropriate length of certification and timing of referrals for other income offset opportunities.
Consults and reviews clinical information with nurses and Medical Directors to establish the appropriate length of certification given contractual provisions and regulatory requirements.
Independently identifies claims that are appropriate for lump sum payout based on ethical and financially sound business practices.
Ensures appropriate and detailed claim documentation to meet risk management, regulatory and accreditation requirements.
Ensures reserve liability is accurately established by maintaining accurate claims data and identifying applicable policy provisions, and claim offsets.
Complies with all applicable state and federal laws and regulations, URAQ and/or NCQA standards, and The Hartford policy and procedures.
Reviews and determines preliminary legal decisions and gathers information for response to department of insurance complaints.
Gathers information and drafts response to department of insurance complaints or inquiries.
WHAT ARE WE LOOKING FOR?
Bachelor's degree or equivalent industry experience.
3-5 years Disability claim management experience is required.
Knowledge of Unfair Claim Settlement Practices Act, ERISA, ADA, and federal, state and local regulations affecting claim investigation, disability decisions, claim payment, taxation and reporting requirements.
Experience performing multiple calculations with a high degree of accuracy, and working in a multi-system (mainframe and Windows) environment.
Strong communication (written/verbal) and business problem solving skills.
Strong computer and literacy skills.
Behaviors at the Hartford
Deliver Outcomes – Demonstrate a bias for speed and execution that serves our shareholders and customers.
Operate as a Team Player – Work together to drive solutions for the good of The Hartford.
Build Strong Partnerships – Demonstrate integrity and build trust with others.
Strive for Excellence – Motivate yourself and others to achieve high standards and continuously improve.
Equal Opportunity Employer/Females/Minorities/Veterans/Disability/Sexual Orientation/Gender Identity or Expression/Religion/Age
* NO AGENCIES PLEASE *
Job: Disability Claims
Primary LocationUnited States-Maine-South Portland
Other LocationsUnited States-Oregon-Portland
Job LevelIndividual Contributor
Education LevelBachelor's Degree (±16 years)
PostingApr 16, 2018, 11:33:51 AM
Remote Worker OptionNo
The Hartford is an equal employment and affirmative action employer. All qualified applicants will receive consideration without regard to race, color, sex, religion, age, national origin, disability, veteran status, sexual orientation, gender identity or expression, marital status, ancestry or citizenship status, genetic information, pregnancy status or any other characteristic protected by law. The Hartford maintains a drug-free workplace and is committed to building inclusion and leveraging diversity.