ERISA Appeals Case Manager II

Guardian; United States; Híbrido; USD 59 000 - 96 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Competitive compensation package

Excellent medical, dental, vision and

Life and disability coverage

401(k) with company match

Tuition assistance and parental leave

Flexible time off and supportive work環

Resumo da oferta

Guardian is seeking an Appeals Case Manager II with experience in Group Disability and Life claims to adjudicate and reconsider appeals under ERISA. You will assess claim files, interpret plan language, and apply applicable regulations to deliver timely, fair decisions.

This mobile role may require travel and proximity to a Guardian office; you will report to the Leader - Appeals Team and work to ensure compliant, high-quality appeal resolutions while supporting the broader claims team.

Qualificações

• Requires 5+ years of Group Disability and/or Life Claims experience.
• Strong verbal and written communication skills.
• Demonstrated problem-solving, analytical, mathematical, and research skills.
• Ability to manage multiple priorities while ensuring regulatory compliance.

Responsabilidades

• Plan, investigate and adjudicate disputed claims to reach timely, fair appeal determinations.
• Identify plan language and thoroughly investigate issues to support non-biased decisions.
• Evaluate medical, financial and other claim information with clinical/vocational input as needed.
• Maintain ERISA and Department of Labor guideline knowledge and ensure compliance.
• Prioritize workload independently to meet deadlines and collaborate with team.

Conhecimentos

Disability/Life claims

Client communication

Analytical thinking

Problem solving

Multitasking

Regulatory compliance

Formação académica

Bachelor's degree or equivalent

Descrição da oferta de emprego

Guardian is seeking an Appeals Case Manager II with experience in Group Disability and Life claims to adjudicate and reconsider appeals under ERISA. You will assess claim files, interpret plan language, and apply applicable regulations to deliver timely, fair decisions.

This mobile role may require travel and proximity to a Guardian office; you will report to the Leader - Appeals Team and work to ensure compliant, high-quality appeal resolutions while supporting the broader claims team.