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Summary:
Manages a caseload of established Disability Income claims, to determine continued benefit eligibility and make accurate payments of benefits. Reviews annual forms for changes in working status and utilizes system tasks to interpret and analyze pertinent facts in making contractual claim decisions.Work directly with customers to create a positive customer experience when answering questions via direct calls or ones received in a call center environment, with the knowledge to analyze problems and handle the research necessary to resolve moderately complex questions from policy owners and Financial Representative. Provide assistance across work group and other claims analysts while following separation of duties guidelines and responsibilities.
Primary Duties & Responsibilities:
Claim Management/Analysis and customer service
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Resolves applicability of benefits claimed by interpreting contract provisions and maintaining consistency with our NM claim philosophy.
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Handles claim files actively by evaluating claim information and making decisions regarding continuing payments.
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When applicable and with guidance from the team lead, orders appropriate financial, medical, investigative, and other information needed to resolve eligibility of claims.
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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.
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Delivers a personalized and remarkable experience for our clients by having a solid understanding of basic contract knowledge and answering their questions, providing servicing options and helping them with their products or services in a call center environment.
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Expert at resolving inquiries and transactions from Financial Reps and clients on basic and intermediate (semi-complex) level calls and transactions and is proficient in complex work.
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Researches and evaluates possible solutions to complex problems that requires identifying root cause and some deviations from procedures.
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Takes ownerships of calls and anticipates future issues to avoid repeat calls and unnecessary call transfers.
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Ability to de-escalate client experience situations effectively while guiding clients through complex and unique inquiries.
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Serves as a trusted advocate for our Financial Representatives and partners with them to meet the needs of our clients.
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Embraces new technology and serves as an advocate for website and self-service capabilities by educating clients and field. Understands risks and impacts that the transaction has on the client or policy.
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Drives change and embraces continuous improvement by creating processes and provisions to accommodate change.
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Handles phone, transactional and claim responsibilities while adhering to strict confidentiality and privacy standards.
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Adept at shifting work priorities to meet the needs of the business and customer demand.
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Appropriately documents claim with telephone conversations, file memos and referrals.
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Prepares written communication with the help of pattern letters, but with guidance from team leader may change the wording when necessary.
Qualifications:
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Bachelor's degree or equivalent combination of education and progressively responsible work experience, preferably in the area of health care, business, insurance, law or communication.
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Knowledge of medical terminology as well as experience with insurance contracts and field servicing preferred.
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One to two years of responsible and relevant work experience demonstrating analytical ability, independent decision making and sound judgment in the application of guidelines.
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Demonstrated ability to analyze complex information and follow through in completing assignments.
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Excellent organizational skills, ability to multi-task and prioritize to meet strict guidelines.
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Strong written and verbal communication skills with ability to deal tactfully, professionally and positively with insureds, Financial Representatives and other customers.
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Ability to handle confidential data in a manner consistent with the Privacy Information Act and Company standards.
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High degree of self-motivation and initiative in taking responsibility for own work while contributing to team goals.
Compensation Range:
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Northwestern Mutual pays on a geographic-specific salary structure and placement in the salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity as well as the cost of labor in the market; and other conditions of employment. At Northwestern Mutual, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. Please note that the salary range listed in the posting is the standard pay structure. Positions in certain locations (such as California) may provide an increase on the standard pay structure based on the location. Please click here for additiona l information relating to location-based pay structures.
We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, disability, age or status as a protected veteran, or any other characteristic protected by law.
If you work or would be working in California, Colorado, New York City, Washington or outside of a Corporate location, please click here for information pertaining to compensation and benefits.
FIND YOUR FUTURE
We're excited about the potential people bring to Northwestern Mutual. You can grow your career here while enjoying first-class perks, benefits, and commitment to diversity and inclusion.
- Flexible work schedules
- Concierge service
- Comprehensive benefits
- Employee resource groups
EEO/AA Employer/Vets/Disability