What are the responsibilities and job description for the Appeals Case Manager I, Group Life and Disability Insurance Claims position at Guardian Life Insurance Company?
Reporting to the Manager, Group Benefits, the Appeals Case Manager is responsible for adjudicating assigned appeals for Group Life and Disability claims. The ACM provides a full and fair reconsideration review by thoroughly assessing the claim file and applying plan provisions in accordance with applicable state and federal regulations. This role primarily supports Group Life, Accidental Death & Dismemberment, Proof of Loss (POL) and select Paid Family Leave (PFL) appeals. However, in the event of an overflow of work, the ACM I may be responsible for the adjudication of Short-Term Disability, Long-Term Disability and Life Waiver of Premium appeals.
You will
- Use effective claim management skills to ensure timely and compliant appeal resolution.
- Identify relevant plan language and thoroughly investigate all claim issues to make an accurate and non-biased appeal determination.
- Evaluate medical, financial, and other claim information in consultation with clinical/vocational professionals for the purpose of resolving disputes.
- Use proactive outreach to provide outstanding customer service to all internal and external customers.
- Maintain current knowledge of all ERISA and Department of Labor guidelines.
- Independently prioritize workload based on individual and departmental deadlines.
You have
- A minimum of 3 years of Group Disability and/or Life claims experience.
- Bachelor’s Degree (preferred) or equivalent professional experience.
- Demonstrated ability to manage multiple tasks in accordance with regulatory requirements.
- A client focus with excellent verbal and written communication skills.
- Strong problem-solving, analytical and information research skills.
- The ability to remain flexible due to changing business needs.
- Ability to work collaboratively with multiple professional fields and diverse populations.
Location
This is a flexible position requiring 2 days a week in an office with preference given to candidates within commuting proximity to a Guardian office which include:
This is a flexible position requiring 2 days a week in an office with preference given to candidates within commuting proximity to a Guardian office which include:
- Bethlehem
- Holmdel, NJ
- Hudson Yards, NY
- Pittsfield, MA
- Atlanta, GA
- Boston, MA
- Bridgewater, MA
- Chicago, IL
- Dallas/Plano, TX
- Newport Beach, CA
- Stamford, CT
- Tempe, AZ
Salary Range
$47,240.00 - $70,865.00
The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
Our Promise
At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Inspire Well-Being
As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues.
Health Care
- Choice of [high deductible/copay] medical plans* with prescription drugs, including coverage for fertility and transgender inclusive benefits
- Dental plan
- Vision plan
- Health care accounts – flexible spending, health reimbursement, and health savings accounts
- Critical illness insurance
Life and Disability Insurance
- Company-paid Life and Disability insurance plus voluntary supplemental coverage
- Accident insurance
Retirement and Financial
- 401(k) retirement plan with a company match, plus an annual age/service-based Company contribution and an annual profit-sharing contribution, if applicable
- Complimentary 1:1 financial guidance with a licensed Fidelity representative
Time Off and Remote Work
- Flexible work arrangements (part in-person/part remote)
- Unlimited paid time off for most roles plus time off for volunteering, jury duty, voting, and bereavement
- Personal holidays for colleagues to use in recognition of religious, cultural, or civic days
- Paid parental leave and paid family and medical leave policies
Emotional Well-being and Work-Life
- Emotional well-being, mental health, and work/life resources powered by Spring Health
- Wellness programs, including fitness program and equipment reimbursement
- Child, adult, and elder back-up care support through Bright Horizons
- Adoption assistance
- College planning
- Tuition reimbursement
- Student loan assistance
- Commuter benefits in select metropolitan areas
Justice, Equity, Diversity & Inclusion (J.E.D.I.)
- Employee Resource Groups that advocate for inclusion and diversity
- J.E.D.I. certification and training programs
- Matching gifts/volunteering
Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.
Equal Employment Opportunity
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
Accommodations
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact
applicant_accommodation@glic.com
.Salary : $47,240 - $70,865
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