Sr STD Case Manager

• Makes timely, accurate, and customer-focused STD and AM new and ongoing claim decisions using advanced independent discretion guided by company procedures and regulatory standards
• handles the most complex claims from a clinical and financial perspective
• reaches out to obtain relevant clinical, vocational, employer, financial, and other information
• compares the information to the terms, limitations, and conditions of the contract/administrative services agreement and applicable procedural documents and renders the claim decision as quickly as possible
• Documents the claims system in an accurate and comprehensive manner
• prepares, updates, and utilizes a claims management plan to attain the most appropriate outcome
• remains in full compliance with regulatory requirements
• demonstrates an above average level of proficiency in product and claims administration techniques
• remains fully compliant with operational standards
• meets or exceeds claims team operational metrics
• Maintains a superior level of genuine caring and empathetic customer service throughout all interactions
• takes appropriate actions to earn the claimant's and employer's trust and confidence
• anticipates customer’s needs and takes action as appropriate
• Works with internal partners to support flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating a dedication to excellence
• Mentors and coaches new team members and participates in projects supporting the team's business initiatives
• Performs other related duties as required

• Strong familiarity with disability claim management concepts
• Strong understanding of medical terminology/pathology/anatomy
• Articulate verbal and writing skills, decision making, meeting deadlines, working with confidential information
• Strong skills with Microsoft Office and other software applications
• Customer service skills
• Stress tolerance
• Math skills
• Ability to multi-task and prioritize
• High level of attention to detail
• Can work under pressure
• Confidence to make claim decisions
• Results-driven
• High attention to departmental/company procedures/practices
• High School Diploma or equivalent
• 3 - 5 years of STD Industry claims management experience
• Demonstrated proficiency in product specific areas of STD, LTD or AM as well as federal and state regulations governing these products and services
• Or an equivalent combination of education and experience

Bachelor's Degree In healthcare or a related field

• Medical, dental, and vision coverage
• Prescription drug coverage
• Health care flexible spending
• Dependent care flexible spending
• Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee)
• 401(k) plans
• Annual bonuses
• Opportunity to purchase company stock
• 11 paid holidays
• Up to 20 days PTO
• State-mandated sick leave (if applicable)
• Other leaves of absence