Sr LTD Claims Analyst

Health Care Service Corporation; Southfield (MI); Remote; USD 54,000 - 122,000; Full time

Job summary

A leading health insurance company seeks a dedicated professional for disability claims management. The successful candidate will manage claim adjudications, deliver exceptional customer service, and collaborate effectively with various stakeholders. Candidates with a strong financial background and fluency in Spanish will be highly regarded.

Benefits

Health and wellness benefits

401(k) and pension plan

Paid time off

Paid parental leave

Disability insurance

Tuition reimbursement

Annual incentive bonus potential

Qualifications

• At least 3 years of claims adjudication experience with LTD disability claims.
• Strong financial background preferred.
• Fluency in Spanish is highly preferred.

Responsibilities

• Provide timely and accurate support to client companies and the claims department.
• Obtain and analyze information to make claim decisions.
• Develop and apply claim management techniques for accurate payments.

Skills

Analytical skills

Clear verbal communication

Clear written communication

Decision-making

Relationship building

Education

BA/BS or equivalent combination of education

Tools

Word

Excel

Outlook

Job description

At Dearborn, our employees are the cornerstone of our business and the foundation of our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for contributing to the overall success of departmental objectives by providing timely and accurate support to our client companies and the claims department. Duties include obtaining and analyzing information to make claim decisions and payments on disability claims, developing and applying appropriate claim and disability management techniques to ensure prompt and accurate payment and liability management, and providing responsive customer service to claimants, policyholders, brokers, and internal departments.

Required Qualifications:

• BA/BS or equivalent combination of education and insurance industry experience.
• At least 3 years of claims adjudication experience with LTD disability claims.
• Experience with computer applications such as Word, Excel, Outlook.
• Experience in decision-making and information analysis.
• Ability to meet deadlines while balancing competing demands.
• Good math and calculation skills.
• Experience meeting or exceeding quotas.
• Experience establishing and maintaining cooperative relationships with internal and external customers.
• Analytical skills.
• Clear and concise verbal and written communication skills.
• Prior experience coaching staff to enable excellence in customer service and claims management, demonstrating role model behavior.
• Knowledge of medical terminology.

Preferred Qualifications:

• Strong financial background.
• Fluency in Spanish is highly preferred.
• Completion of HIAA, LOMA, or ICA courses is preferred.

This role is remote.

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Pay Transparency Statement:

At Dearborn, you will be part of an organization committed to offering meaningful benefits to support your life outside of work, including health and wellness benefits, 401(k), pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, and other incentives. The compensation offered will vary depending on your skills, education, knowledge, and experience. This role may be eligible for an annual incentive bonus, subject to plan terms and conditions.

Equal Opportunity Employment

We are an Equal Opportunity Employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or other protected characteristics.

Base Pay Range

$54,800.00 - $121,100.00