Social Security Claims Examiner II, Claims

The Role at a Glance

We are excited to bring on a Social Security Specialist to join our Financial Services Organization supporting Group Protection.

Background Details

This position will perform and deliver on routine and non-routine Social Security Disability Insurance (SSDI) assignments independently in accordance with established procedures/guidelines. They will act as a liaison between internal benefits teams, claimants, and any legal representation. They will provide claimants with detailed information regarding SSDI benefits and how such benefits can be used in conjunction with disability insurance policies. They will monitor claimants’ SS claims until a final decision is received.

What you'll be doing

• Supports and promotes change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.
• Meets or exceeds departmental quality and service standards.
• Works overtime as needed.
• Delivers routine work independently, in accordance with established procedures and guidelines, in a timely manner and meets deadlines appropriately.
• Makes routine & non-routine decisions, applying limited but increasingly more discretion within role except for matters of significance which affect the business as a whole or a significant part of it, in accordance with established procedures & guidelines
• Applies expanded knowledge obtained from the role in increasingly more complex situations and continues to acquire more knowledge to apply in role.
• Provides a diverse range of information and performs a diverse range of tasks/transactions related to common programs and services.
• Reviews and interprets disability insurance policies with specific attention to provisions related to other income and/or offsets.
• Contacts and educates claimants eligible for SSDI benefits. Explains both the differences and coordination between the disability policy/benefits and the SSA's benefits/adjudication.
• Provides initial guidance and continues on-going communication with claimants regarding their SS responsibilities and follow-up items until a final determination is made.
• Accurately posts SS offsets in applicable system(s).
• Develops and maintains working relationships with SSDI vendors and/or claimant attorneys.
• Works closely with internal benefits/claims teams; regularly providing information and updates regarding Social Security eligibility and determinations.
• Recognizes issues and raises concerns to management, with recommendations for improvement.
• Takes initiative to investigate issues and identify root causes; recommends solutions to improve operational effectiveness.
• Maintains and updates knowledge of SSDI guidelines and departmental policies & procedures.
   

What we’re looking for

Must-have experience (Required):

• High School diploma or GED or minimum Associate degree in lieu of required experience. (Minimum Required)
• 2 - 3 Years’ experience in claims or other insurance operations directly aligned to the specific duties for this role OR for candidates with an Associate degree or above, 0-1 year experience in claims or other insurance operations directly aligned to the role (Required)
• Effective strong written and verbal communication skills.
• Ability to maneuver through multiple systems/databases/platforms/software. 
• Ability to be adaptable/flexible as business needs change. 

Nice-to have Experience (Preferred):  

• Ability to problem solve and make independent decisions, while providing compassionate customer service.
• Research and data entry experience in a fast-paced environment. 
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).