Job Information
Guardian Life Complex Claims Manager, Long Term Disability Claims in Helena, Montana
Complex Claims Manager, LTD Claims
The Complex Claims Manager, LTD Claims is responsible for making accurate decisions on assigned complex claims according to the plan provisions, state and federal guidelines, and established protocols. This position will manage a portfolio of claims which have complexities driven by things including but not limited to specialized contractual requirements, unique earnings, complex medical conditions, specialized occupational demands and/or the presence of potential fraud, waste and abuse indicators.
You are:
A highly motivated and reliable individual who is able to work with varying levels of supervision – independently and collaboratively. You are detail oriented and a decisive decision maker who is able to manage multiple complex priorities at the same time with a positive attitude.
You have:
A minimum of 2 years of Group LTD claims experience
Bachelor’s Degree (preferred) or equivalent professional experience
A client focus with excellent verbal and written communication skills.
Demonstrated ability to manage multiple tasks in accordance with regulatory requirements
The ability to remain flexible due to changing business needs
Excellent written and verbal communication skills
Ability to exercise independent and sound judgement in decision making
Ability to analyze evidence for discrepancies
Ability to conduct research using multiple techniques
Excellent time management and organizational skills
Basic computer skills and knowledge, including Microsoft Office
Understanding of basic medical terminology and medical conditions helpful
You will:
Utilize strong claim management skills to plan, implement and execute the investigation of a case load of complex LTD claims
Identify and interpret relevant plan language and thoroughly investigate all claim issues to make accurate and non-biased claim determination
Evaluate complex medical, occupational, financial and other claim information in consultation with clinical, vocational or financial specialists internal and/or external to the company
Partner with the legal department as needed to evaluate the application of complex contractual provisions
Maintain current knowledge of all ERISA and Department of Labor guidelines
Independently prioritize workload based on individual and departmental deadlines
Evaluate appeal reversals to establish ongoing claim management plans
Readily share insights and learnings with claims colleagues
Strategize with multiple business partners as appropriate on complex claim matters to help drive the most appropriate claim outcomes
Leadership Behaviors
Continuously strives to provide superior products and customer service
Expresses oneself in an open and honest manner
Demonstrates self-awareness and embraces feedback
Reporting Relationship:
The Complex Claims Case Manager, LTD Claims reports to the Manager, LTD Complex Claims and Financial Management
Salary Range
$56,200.00 - $92,335.00
The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
Our Promise
At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Inspire Well-Being
As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.
Health Care
Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits
Dental plan
Vision plan
Health care accounts – flexible spending, health reimbursement, and health savings accounts
Critical illness insurance
Life and Disability Insurance
Company-paid Life and Disability insurance plus voluntary supplemental coverage
Accident insurance
Retirement and Financial
401(k) retirement plan with a company match, plus an annual age/service-based Company contribution and an annual profit-sharing contribution, if applicable
Complimentary 1:1 financial guidance with a licensed Fidelity representative
Time Off and Remote Work
Flexible work arrangements (part in-person/part remote)
Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement
Personal holidays for colleagues to use in recognition of religious, cultural, or civic days
Paid parental leave and paid family and medical leave policies
Emotional Well-being and Work-Life
Emotional well-being, mental health, and work/life resources powered by Spring Health
Wellness programs, including fitness program and equipment reimbursement
Child, adult, and elder back-up care support through Bright Horizons
Adoption assistance
College planning
Tuition reimbursement
Student loan assistance
Commuter benefits in select metropolitan areas
Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.
Equal Employment Opportunity
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
Accommodations
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact applicant_accommodation@glic.com .
Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being — mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com .