Remote Appeals Case Manager II – Disability & Life

Guardian Life; Salt Lake City (UT); Remote; USD 59,000 - 96,000; Full time

Benefits offered by this job

Remote work

Tuition assistance

Parental leave

Backup family care

401(k) with company match

Job summary

Guardian Life is seeking an Appeals Case Manager II (ACM 2) to adjudicate assigned group life and disability appeals with a full and fair reconsideration review under ERISA. This remote/mobile role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals.

You will prioritize investigative work, interpret plan language, and evaluate medical and financial information with input from clinical professionals to render accurate appeal determinations while

Qualifications

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

Responsibilities

• Plan, investigate and adjudicate disputed claims to provide timely, compliant appeal determinations.
• Identify relevant plan language and interpret issues to resolve disputes fairly.
• Evaluate medical, financial and other information with clinical/vocational input as needed.
• Provide proactive customer service to internal and external customers.
• Identify and research legal/compliance scenarios requiring further work.
• Maintain knowledge of ERISA and Department of Labor guidelines.

Skills

Group Disability claims experience

Strong communication skills

Analytical skills

Multi-tasking

Education

Bachelor's degree or equivalent

Tools

ERISA knowledge

Job description

Guardian Life is seeking an Appeals Case Manager II (ACM 2) to adjudicate assigned group life and disability appeals with a full and fair reconsideration review under ERISA. This remote/mobile role supports Group Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals.

You will prioritize investigative work, interpret plan language, and evaluate medical and financial information with input from clinical professionals to render accurate appeal determinations while