Senior STD Case Manager

Jobtailor; Farmington (CT); On-site; USD 70,000 - 95,000; Full time

Job summary

Jobtailor in Farmington, CT is seeking a claims professional to make timely STD/AM decisions and manage complex cases. You will document cases, collaborate with internal partners, and mentor new staff while upholding regulatory requirements. A strong background in disability claims and medical terminology is essential.

This role emphasizes empathy, accuracy, and adherence to procedures. Qualifications include a high school diploma, 3–5 years of STD industry experience, and proficiency in

Qualifications

• Strong familiarity with disability claim management concepts.
• Strong understanding of medical terminology/pathology/anatomy.
• Articulate verbal and writing skills, decision making, meeting deadlines, working with confidential information.
• Strong skills with Microsoft Office and other software applications.
• Customer service skills
• Stress tolerance
• Math skills
• Ability to multi-task and prioritize
• High level of attention to detail
• Can work under pressure
• Confidence to make claim decisions
• Results-driven
• High attention to departmental/company procedures/practices
• High School Diploma or equivalent
• 3 - 5 years of STD Industry claims management experience
• Demonstrated proficiency in product specific areas of STD, LTD or AM as well as federal and state regulations governing these products and services
• Or an equivalent combination of education and experience

Responsibilities

• Makes timely, accurate, and customer-focused STD and AM new and ongoing claim decisions using advanced independent discretion guided by company procedures and regulatory standards.
• Documents the claims system in an accurate and comprehensive manner; prepares, updates, and utilizes a claims management plan to attain the most appropriate outcome.
• Maintains a superior level of genuine caring and empathetic customer service throughout all interactions.
• Works with internal partners to support flexibility, collaboration, creating a positive work environment.
• Mentors and coaches new team members and participates in projects supporting the team’s business initiatives.
• Performs other related duties as required.

Skills

Disability claims

Medical terminology

Verbal communication

Decision making

Confidential information

Customer service

Stress tolerance

Multi-tasking

Attention to detail

Time management

Math skills

Education

High School Diploma or equivalent

3-5 years STD Industry claims experience

Regulatory knowledge (federal/state)

Tools

Microsoft Office

Job description

Responsibilities

• Makes timely, accurate, and customer-focused STD and AM new and ongoing claim decisions using advanced independent discretion guided by company procedures and regulatory standards; handles the most complex claims from a clinical and financial perspective; reaches out to obtain relevant clinical, vocational, employer, financial, and other information; compares the information to the terms, limitations, and conditions of the contract/administrative services agreement and applicable procedural documents and renders the claim decision as quickly as possible.
• Documents the claims system in an accurate and comprehensive manner; prepares, updates, and utilizes a claims management plan to attain the most appropriate outcome; remains in full compliance with regulatory requirements; demonstrates an above average level of proficiency in product and claims administration techniques; remains fully compliant with operational standards; meets or exceeds claims team operational metrics.
• Maintains a superior level of genuine caring and empathetic customer service throughout all interactions; takes appropriate actions to earn the claimant’s and employer’s trust and confidence; anticipates customer’s needs and takes action as appropriate.
• Works with internal partners to support flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating a dedication to excellence.
• Mentors and coaches new team members and participates in projects supporting the team’s business initiatives.
• Performs other related duties as required.

Requirements

• Strong familiarity with disability claim management concepts
• Strong understanding of medical terminology/pathology/anatomy
• Articulate verbal and writing skills, decision making, meeting deadlines, working with confidential information
• Strong skills with Microsoft Office and other software applications
• Customer service skills
• Stress tolerance
• Math skills
• Ability to multi-task and prioritize
• High level of attention to detail
• Can work under pressure
• Confidence to make claim decisions
• Results-driven
• High attention to departmental/company procedures/practices
• High School Diploma or equivalent
• 3 - 5 years of STD Industry claims management experience
• Demonstrated proficiency in product specific areas of STD, LTD or AM as well as federal and state regulations governing these products and services
• Or an equivalent combination of education and experience