DI Claims Specialist

Northwestern Mutual

6d

About The Position

Primary Duties & Responsibilities • Determine applicability of benefits claimed by interpreting contract provisions and maintaining consistency with our Disability Benefits claim philosophy. • Order and review appropriate medical, financial, investigative, and other information needed to determine the eligibility of claims. • Actively manage a caseload of pending and active claim files by evaluating claim information and making decisions regarding approval, denial, continuing payments, and terminations on a regular, ongoing basis. • Communicate both verbally and in writing with insureds, field representatives, medical practitioners and related facilities, attorneys, other insurance companies, appointed financial advisors, employers, governmental agencies and divisional resources which involves negotiation and conflict resolution. • Preserve Northwestern Mutual's image and reputation in making benefit decisions despite difficult and delicate circumstances. • As part of the claim handling process, may be called upon to represent the Company in legal matters through preparation for and participation in depositions and trials. • Approval limits: $0-$6,000 contestable and non-contestable claims. Qualifications • Bachelor's degree, experience in administering disability claims, or equivalent work experience. • 1-3 years of responsible and relevant work experience demonstrating analytical ability, independent decision-making and sound judgment in the application of guidelines. • Ability to collaborate within and across teams to obtain the best possible results. • Excellent organization and communication skills with emphasis on written communication

Requirements

• Bachelor's degree, experience in administering disability claims, or equivalent work experience.
• 1-3 years of responsible and relevant work experience demonstrating analytical ability, independent decision-making and sound judgment in the application of guidelines.
• Ability to collaborate within and across teams to obtain the best possible results.
• Excellent organization and communication skills with emphasis on written communication

Responsibilities

• Determine applicability of benefits claimed by interpreting contract provisions and maintaining consistency with our Disability Benefits claim philosophy.
• Order and review appropriate medical, financial, investigative, and other information needed to determine the eligibility of claims.
• Actively manage a caseload of pending and active claim files by evaluating claim information and making decisions regarding approval, denial, continuing payments, and terminations on a regular, ongoing basis.
• Communicate both verbally and in writing with insureds, field representatives, medical practitioners and related facilities, attorneys, other insurance companies, appointed financial advisors, employers, governmental agencies and divisional resources which involves negotiation and conflict resolution.
• Preserve Northwestern Mutual's image and reputation in making benefit decisions despite difficult and delicate circumstances.
• As part of the claim handling process, may be called upon to represent the Company in legal matters through preparation for and participation in depositions and trials.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level