Operations Assistant
Assistantly
Salary
💰 $54,900 - $82,400 per year
Job Level
Mid-LevelSenior
About the role
- Manage customer service, benefit payment process and financial risk for assigned Long-Term Disability claims
- Apply contractual provisions, legal guidelines and claims procedures to decide on claim acceptance, denial and benefit duration
- Communicate rationale with confidence and sensitivity
- Manage and prioritize a group of claims and maintain documentation
- Obtain necessary information to evaluate claim credibility
- Prepare written rationale of claim decision based on contract and medical/occupational records
- Process claims for payment and ensure accurate timely benefits payment
- Assess vocational rehabilitation opportunities and work with vocational staff
- Use investigative tools, may testify in court and provide depositions related to claim disputes
Requirements
- Bachelor's Degree preferred, or relevant work experience
- Excellent written and verbal communication skills with customer service orientation
- Must be able to work independently and in a team environment
- Ability to conduct detailed claimant interviews
- Solid critical thinking skills as well as the ability to negotiate with people
- Demonstrated expert analytical skills with the ability to think creatively and address the strengths and weaknesses of a claim and the fine distinctions in contract language
