Remote Appeals Case Manager II

Guardian Life; Atlanta (GA); Remote; USD 59,000 - 96,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

401(k) with company match

Tuition assistance

Paid parental leave

Job summary

Guardian Life is seeking Appeals Case Manager II to adjudicate ERISA-based appeals for Group Life and Disability claims. This remote US role supports Short-Term Disability, Long-Term Disability, and Life Waiver of Premium appeals.

You will navigate complex files, plan language, and regulatory guidelines to render fair outcomes while maintaining customer service excellence across internal and external stakeholders.

Qualifications

• Minimum 5 years of Group Disability and/or Life Claims experience.
• Strong client focus with excellent verbal and written communication.
• Demonstrated problem-solving, analytical, mathematical, and research skills.

Responsibilities

• Plan, investigate and resolve disputed claims in a timely, compliant manner.
• Interpret plan language and investigate issues for accurate appeal determinations.
• Evaluate medical and financial information with clinical/vocational input as needed.
• Provide proactive outreach to internal and external customers.
• Identify legal/compliance scenarios requiring additional research.

Skills

Group Disability claims

Claims investigations

Analytical skills

Communication skills

Regulatory knowledge

Education

High School Diploma or GED

Bachelor's degree

Job description

Guardian Life is seeking Appeals Case Manager II to adjudicate ERISA-based appeals for Group Life and Disability claims. This remote US role supports Short-Term Disability, Long-Term Disability, and Life Waiver of Premium appeals.

You will navigate complex files, plan language, and regulatory guidelines to render fair outcomes while maintaining customer service excellence across internal and external stakeholders.