Cigna Group Claims Associate LTD - Glendale, CA - January 28th 2019 Start! in Glendale, California
The Long Term Disability Claims Manager will manage an assigned caseload of more complex Long-Term Disability cases. This includes management of claims with longer duration and evolving medical conditions. It also requires potentially complex benefit calculations on a monthly basis. The candidate will also evaluate claimant eligibility and interact with internal and external customers including, but not limited to, claimants, employers, physicians, internal business matrix partners and attorneys etc. to gather the information to make the decision on the claim.
As a Long Term Disability Claims Manager, you will:
• Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented
• Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
• Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information
• Pay all covered claims accurately and timely
• Execute on all customer performance guarantees
• Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner
• Manage both new claims and open claims equally and maintains decision times
• Adhere to standard timeframes for processing mail, tasks and outliers
• Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.)
• Understand Cigna Group Operations and Corporate Compliance, Polices and Procedures and best practices
• Stay abreast of ongoing trainings associated with role and business unit objectives
• High School Diploma or GED required. Bachelor's degree strongly preferred.
• 1 year minimum of professional experience is strongly preferred.
• Experience in hospital administration, medical office management, financial services and/ or business operations is a ( )
• Excellent organizational and time management skills.
• Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously
• Proficiency with MS Office applications is required (Word, Outlook).
• Strong written and communication skills demonstrated in previous work experience.
• Specific experience with collaborative negotiations.
• Proven skills in positive and effective interaction with challenging customers.
• Experience in effectively meeting/exceeding individual professional expectations and team goals.
• Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
• Demonstrated analytical and math skills.
Primary Location: Glendale-California
Work Locations: 400 North Brand Blvd Glendale 91203
Job: Bus Ops--Claims
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Job Posting: Nov 14, 2018, 3:21:21 PM
Qualified applicants will be considered for employment without regard to age, race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. Need an accommodation? Email: SeeYourself@cigna.com