Remote Appeals Case Manager - Disability & Life

Guardian Life; Denver (CO); Remote; USD 59,000 - 96,000; Full time

Benefits offered by this job

401(k) with company match

Excellent medical, dental, vision保险

Tuition assistance

Flexible time off and remote work

Employee Resource Groups

Job summary

Guardian Life is seeking an Appeals Case Manager II to adjudicate assigned appeals for Group Life and Disability claims, performing full and fair reconsiderations under ERISA. This mobile role supports Group Short-Term Disability, Long-Term Disability, and Life Waiver of Premium appeals.

You will manage investigations, interpret plan language, consult with clinical/vocational experts, and maintain knowledge of ERISA and DOL guidelines while delivering customer service and compliant resolutions.

Qualifications

• Minimum of 5 years experience in Group Disability and/or Life Claims.
• Strong client-focused verbal and written communication.
• Demonstrated problem-solving, analytical, and research skills.
• Ability to manage multiple priorities while ensuring regulatory compliance.
• Flexibility to adapt to changing business needs.

Responsibilities

• Plan, investigate and resolve disputed claims to provide fair appeal determinations.
• Identify plan language and thoroughly investigate issues.
• Evaluate medical and financial information with professionals to resolve disputes.
• Provide proactive outreach and superior customer service to internal and external customers.
• Stay current on ERISA and Department of Labor guidelines; prioritize workload accordingly.
• Share insights with claims colleagues.

Skills

Group Disability Claims

Life Claims

Client-focused communication

Analytical thinking

Regulatory compliance

Adaptability

Education

Bachelor's degree or equivalent

Job description

Guardian Life is seeking an Appeals Case Manager II to adjudicate assigned appeals for Group Life and Disability claims, performing full and fair reconsiderations under ERISA. This mobile role supports Group Short-Term Disability, Long-Term Disability, and Life Waiver of Premium appeals.

You will manage investigations, interpret plan language, consult with clinical/vocational experts, and maintain knowledge of ERISA and DOL guidelines while delivering customer service and compliant resolutions.