Job description
The work we do has an impact on millions of lives, and you can be a part of it.
We help protect our customers against life’s uncertainties. Regardless of where you work within the company, you’ll be helping provide protection and peace of mind when our customers need it most.
The Claims Specialist works in a team environment to process tasks associated with State-Mandated Disability Claims. This customer-facing position requires excellent written and verbal communication skills to provide top-quality service to claimants and policy-holders. A professional demeanor and a strong desire to help others are essential.
To be successful in this role, the candidate must possess strong critical thinking, organizational, and time management skills, along with a keen attention to detail due to the personal nature of the payouts involved. This role requires experience with and knowledge of State-Mandated Disability Leave, short-term and long-term disability, or FMLA leave administration and claims.
The ideal candidate will have above-average communication and data entry skills, a natural curiosity to learn, and the ability to quickly assimilate new information. They should also be comfortable with technology and adaptable to continuous improvements in both technology and work processes.
Key Responsibilities
- Understand and appropriately apply department processes and regulatory policies.
- Manage new, continuous, and/or periodic claims by continually reviewing and prioritizing incoming mail and correspondence to ensure mandated turnaround times are achieved.
- Perform outreach to claimants, policyholders, and healthcare providers via telephone and/or in writing to obtain information needed for initial and ongoing claim management.
- Conduct reviews of claimant, employer, and medical information, along with other relevant information, to accurately and timely determine benefit eligibility, claim duration, and benefits payable (including the proper application of taxes).
- Escalate complex claim situations to Subject Matter Expert and/or Claims Supervisor.
- Accurately and thoroughly document claim file actions and conversations.
- Achieve, and preferably exceed, departmental hourly/daily claim (task) output productivity goals.
- Make accurate determinations to approve, pend, or deny claims consistent with department processes on all assigned claims.
- Achieve, and preferably exceed, departmental financial and statistical quality standards. Review, process, and respond to Quality Audits/Audit Correspondence.
- Promote a positive customer experience through prompt, accurate, and courteous services to both internal and external customers.
- Contribute to a positive work environment while working with various other departments to ensure achievement of departmental and corporate goals and objectives.
- Contribute to the department’s various project work and assignments, as needed.
Skills and Abilities:
- Strong customer service and communication skills
- Attention to detail and organizational skills
- Technological aptitude and adaptability
- Teamwork and problem-solving abilities
- Knowledge of federal and state laws on leaves of absence
- Ability to evaluate and process disability and leave claims
- Proficiency in Microsoft Excel and Word
Minimum Requirements
- High School diploma required
- College degree or an equivalent of at least three (3) years of work experience preferred.
- 1-2 years’ experience in a disability claims environment.
- Experience with state mandated disability claims is highly preferred.
Schedule Details
- This role operates on a semi-flex 40 hour a week, M-F schedule. All schedules will be approved based on business needs.
$45,000 - $55,000 a year
Protective’s targeted salary range for this position is $45,000-55,000. Actual salaries may vary depending on factors, including but not limited to, job location, skills, and experience. The range listed is just one component of Protective’s total compensation package for employees.
#ind123
Employee Benefits:
We aim to protect the wellbeing of our employees and their families with a broad benefits offering. In addition to offering comprehensive health, dental and vision insurance, we support emotional wellbeing through mental health benefits and an employee assistance program. Work/life balance is important and Protective offers a variety of paid time away benefits (e.g., paid time off, paid parental leave, short-term disability, and a cultural observance day). The financial health of our employees is just as important as physical and emotional health. Some of the financial wellbeing benefits include contributions to healthcare accounts, a pension plan, and a 401(k) plan with Company matching. All employees are encouraged to protect their overall wellbeing by engaging in ProHealth Rewards, Protective’s platform to improve wellbeing while earning cash rewards.
Eligibility for certain benefits may vary by position in accordance with the terms of the Company’s benefit plans.
Accommodations for Applicants with a Disability:
If you require an accommodation to complete the application and recruitment process due to a disability, please email [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application and recruitment process.
Please note that the above email is solely for individuals with disabilities requesting an accommodation. General employment questions should not be sent through this process.
We are proud to be an equal opportunity employer committed to being inclusive and attracting, retaining, and growing an inclusive workforce.
