Location: Franklin, WI Corporate, United States
Company: North Western Mutual
Job Position: DI Benefits Specialist
JOB DESCRIPTION:
Qualification:
Education & Experience
Bachelor's degree, experience in administering disability claims, or equivalent work experience.
- One to three 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.
Job Responsibility:
Determines applicability of benefits claimed by interpreting contract provisions and maintaining consistency with our Disability Benefits claim philosophy.
- Orders and reviews appropriate medical, financial, investigative, and other information needed to determine the eligibility of claims.
- Manages claim files actively by evaluating claim information and making decisions regarding approval, denial, continuing payments, and terminations on a regular, ongoing basis.
- Communicates 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.
- Preserves 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