Group Life Claims Examiner II

Date: Mar 27, 2019

Location: Dover, NH, US

Company: Lincoln Financial

 

 

 

 

 

Alternate Locations: Charlotte, NC (North Carolina); Dover, NH (New Hampshire)

 

 


Relocation assistance is not available for this opportunity.

 



Requisition #58288

 


About the Company

 

Lincoln Financial Group, a Fortune 250 company with over 10,000 employees, provides advice and solutions that help empower Americans to take charge of their financial lives with confidence. Our core business areas — Life Insurance, Annuities, Retirement Plan Services and Group Protection — focus on supporting, preserving and enhancing over 17 million customer’s lifestyles and retirement outcomes.

 

Headquartered in Radnor, Pennsylvania, Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. The company had $253 billion in assets under management as of December 31, 2017.

 

Ranked one of the Best Large Employers in America by Forbes magazine, Lincoln Financial Group makes a serious investment in our employees’ futures through a broad range of wealth accumulation and protection plans, health and wellness programs, and career development resources designed to help each individual reach their personal and professional goals.

 

The Role

Conducts the review, investigation, liability determination and management of Employer Life claims with varying complexity. Research and apply the appropriate contractual provisions, legal guidelines; case management resources; and claim procedures, concepts, principles, protocols to manage claims and render decisions. Work with outside vendors to obtain necessary information to make the appropriate decision on the claim.

Responsibilities

  • Reviews, investigates and manages caseload assigned to meet productivity, quality, and time service standards.  Maintain detailed knowledge of claims practices, policies and procedures.
  • Works with mentor/leader to make payment determination applying appropriate contractual provisions and payment calculations using claims system, as well as applicable state liens checks, to manage and pay claims while meeting all service, timeframe and production standards. Provide secondary claims review and payment approval support for Claims team.
  • Ensure compliance with all state and federal regulations and internal department procedures and goals; legal guidelines case management resources; and claim procedures, concepts, principles, and protocols to risk manage life claims
  • Responds to various written and telephone inquiries including eligibility, approval/denial determinations, status and continuation or closure of benefits.
  • Provides high-touch service through Personalized Case Management to our beneficiaries.
  • Identifies and appropriately handles suspicious claims, partnering with senior team members for guidance and assistance.

Requirements

  • Associates Degree or higher preferred
  • Intermediate level knowledge of life insurance, contracts, riders, benefits and agreements; in-depth understanding of applicable state/federal regulations
  • Effective critical thinking, problem solving, and decision making skills
  • Effective verbal and written communication skills to exchange complex information from various sources
  • Customer focus with demonstrated ability to empathize with beneficiaries
  • Tact, composure and professionalism
  • Time management and organizational skills
  • Knowledge, skills and other capabilities normally acquired through Bachelor’s degree (or equivalent relevant experience) and at least one or more years of life claims experience
  • Group Benefits claims experience preferred

 

 

 


This position may be subject to Lincoln’s Political Contribution Policy.  An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information.  Applicants are evaluated on the basis of job qualifications.  If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

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Nearest Major Market: Dover

Job Segment: Claims, Liability, Compliance, Insurance, Legal