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Claims Services & Settlement Specialist

Company: Reliance Standard
Location: Philadelphia
Posted on: February 15, 2019

Job Description:

Job Description:

Key Responsibilities: Settlement Analysis and Facilitation
--- Independently renders appropriate settlement determinations based on a review of all available information and the terms and provisions of the applicable policy. Sr. Leadership sign off is required at a certain dollar limit.
--- Effectively manages appropriate volumes, consistently meets turnaround times, high activity levels, and quality focus on timely settlement resolutions.
--- Acts as the sole liaison to our Extended Duration Team (outsourced 3rd party) as a subject matter expert, addressing the most complex issues of Long Term Disability Claims.
--- Processes payments for both internal and vendor facilitated settlements through an RSL internal system.
--- Handles claims administration for sensitive situations, as necessary, to include aggressive claimants or those threatening a lawsuit, etc.
--- Utilizes reports to track and analyze settlement activities and results for review by Sr. Leadership. Vendor Administration
--- Adds, removes and maintains user access to vendor portals and systems; this is accomplished through file uploads.
--- Ensures compliance with HIPPA by regularly reviewing access Protected Health Information (PHI) and/or Personal Identification Information (PII).
--- Maintains Vendor Operations' forms, documents, and letters within Vendor Portals.
--- Will outsource difficult claims to an outside vendor for a determination. Required Knowledge, Skills, Abilities, Competencies, and/or Related Experience:
--- Associates Degree (AS/AA), Bachelors Preferred (Business, Finance, Social Work or Human Resources).
--- Associate LOMA Designation preferred.
--- 5 years LTD disability claims or related experience.
--- Advanced understanding of Long Term Disability Claim's management techniques.
--- Ability to analyze information to make independent decisions.
--- Experience working in confidential/protected identification environments.
--- Knowledge of medical terminology.
--- Excellent math and calculation skills.
--- Advanced excel knowledge.
--- Proven ability to work well in a high-visibility, public-oriented environment.
--- Experience mentoring or training others.
--- Demonstrated ability to coach and mentor.
--- Sales and/or negotiation experience.
--- Experience with claims administrative systems preferred.Ability to Travel: None

Keywords: Reliance Standard, Philadelphia , Claims Services & Settlement Specialist, Other , Philadelphia, Pennsylvania

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