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| Contact: |
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Lincoln Financial Group is leading the industry in redefining financial security for its customers. Employing a strategy that goes beyond accumulation and protection to include income and enjoyment, Lincoln provides a full suite of products and services to help its customers achieve a common goal: retirement income security.
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| Senior Disability & Life Appeals Specialist |
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| Company: |
Lincoln Financial Group |
Required Education: |
Not Specified |
| Job Type: |
Insurance |
Required Experience: |
Not Specified |
| Base Pay: |
N/A |
Required Travel: |
None |
| Other Pay: |
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Location: |
 US-NE-Omaha
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| Employee Type: |
Full-Time |
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| Manages Others: |
Not Specified |
| Relocation Covered: |
No |
| Industry: |
Insurance |
| Reference ID: |
IRC16831 |
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Responsible for risk managing and appeals, which includes investigation, evaluation, interpretation and resolution of STD and LTD claims. Essential Job Functions: - Responsible for interpretation of contract provisions and vocational and medical records
- Independently, solves problems and interprets and explains complex claim situations to claimants, policyholders, attorneys, physicians and brokers
- Responsible for effective interaction with claimants, policyholders, attorneys, physicians and brokers in oral and written form
- Must maintain internal and external customer satisfaction in the resolution of claim-specific issues
- Conducts effective high level negotiations in identifying potential settlements and works closely with the Risk Management
- In the resolution of disability issues, interacts with the Legal department relative to compliance, legislative, legal and regulatory issues
- Actively leads an/or participates in identifying trends and in the development of new and improved risk management strategies
- Must lead by example and by coaching, providing feedback, and mentoring to improve quality of appeal claim practices and processes
- Provides mentoring on technical issues to risk staff
- Leads and/or works on complex projects as directed
- Responsible for responding to Presidential and Insurance Department complaints in a timely and effective manner
- Must maintain clear and concise claims documentation on system
- Reviews, evaluates and presents file information to Appeals Council
- College degree or equivalent work experience is required
- Three to five years Disability claims experience is required
- Proven ability to read and correctly interpret a Disability contract is mandatory
- Strong knowledge of IBM software programs, including, but not limited to: word processing software, spreadsheet software and e-mail
- In depth knowledge of medical terminology is necessary
- Completion of Group HIAA, LOMA, ICA and other industry courses is desirable
- Strong math skills are required
- Ability to use logic, accuracy and strict attention to detail are mandatory
- Must possess excellent analytical, problem solving and communication skills
- Prior mentoring experience is necessary
- Regular and predictable attendance is required
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