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Claims Examiner III Workers' CompensationCLAIM YOUR FUTURE AS A GREAT PERFORMER!Continuing doubledigit revenue growth rates and progressive employment practices ...
Assoc DirectorMfg Tech CMC Reg Support(00880254) Location New Jersey Branchburg Education Required Bachelors Job ID 50428505 Years of Experience Not Indicated ...
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Overview: If you want to make a positive difference and stand out from the crowd, you'll fit in at The Standard (). Through our retirement plans and insurance products and services, we help provide people with the financial security and confidence to pursue their dreams. Come join us and share our passion for serving our customers in a positively different way.
Job Summary
Secure and analyze claim information to make and approve disability decisions and payments on straightforward, non-complex short term disability and/or state disability insurance claims; apply appropriate procedures and claim management strategies to ensure prompt and accurate payment and liability management of a significant volume of low-complexity claims; provide responsive and caring customer service to claimants, policyholders, and others.
Responsibilities: Principal Duties & Responsibilities
Investigate, secure and analyze information pertaining to claimants' medical condition, occupational demands, insured status and other policy provisions to accurately determine eligibility for and entitlement to disability benefits for low-complexity short term disability and/or state disability insurance claims; identify file/fact discrepancies and outstanding issues and secure additional documentation as needed while acting within prescribed timeframes and service expectations. Make and communicate disability decisions and issue correct benefits for new and continuing claims.
Execute processes and claim management strategies for each claim to appropriately contain claim liability and provide responsive and caring customer service; ensure that each claimant's ongoing and changing medical condition, applicable policy limitations and provisions, applicable statutory requirements, ability to return to work, and deductible income are investigated, applied and pursued, and used to reach timely and appropriate claim resolution; and so that claims are managed to the correct payment duration. Transition more complex claims appropriately to Examiners or Senior Examiners
Provide accurate and appropriate claim information to claimants, policyholders, sales offices, and other interested parties; resolve issues through effective oral and written communication and by appropriately involving senior and management staff.
Ensure the company's reserve liability is accurately established by identifying all applicable deductible income and maintaining accurate claim payment and system data.
Qualifications: Job Specifications
1. Education: High School diploma or equivalent. Associate degreee in business, science or related field, highly desirable.
2. Experience: One year of related work experience or prior customer service experience. Attention to detail and accuracy; express ideas clearly in written and verbal form; prioritize tasks to meet multiple and changing deadlines; accurately keyboard 35 WPM.
3. Professional certification required: None
Standard Insurance Company, The Standard Life Insurance Company of New York, Standard Retirement Services, Inc., StanCorp Equities, Inc. and StanCorp Investment Advisers, Inc., marketed as The Standard, are Affirmative Action/Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, national origin, gender, sexual orientation, age or any other condition protected by federal, state or local law. The Standard offers a drug and alcohol free work environment where possession, manufacture, transfer, offer, use of or being impaired by an illegal substance while on Standard property, or in other cases which the company believes might affect operations, safety or reputation of the company is prohibited. The Standard requires a criminal background investigation, drug test, employment, education and licensing verification as a condition of employment. All employees of The Standard must be bondable.
