Positions in this function are responsible for providing expertise or general claims support to teams in reviewing, researching, investigating, negotiating, processing and adjusting claims. Authorizes the appropriate payment or refers claims to investigators for further review. Conducts data entry and re-work; analyzes and identifies trends and provides reports as necessary.
- Review and render determinations on Long Term Disability claims.
- Initiate and maintain appropriate level of communication within ERISA standards through the claim review and investigation process.
- Respond to all inquiries generated relative to Long Term Disability claims within established service time frame.
- Provide accurate claim decisions in accordance with Policy, State and Federal guidelines.
- Adjudicate Long Term Disability claims
- Analyzes and investigates.
- Provides explanations and interpretations within area of expertise.
- High School Diploma / GED or higher
- 2+ years of experience providing customer service to policy holders, employers, internal and external customers
- 2+ years of experience analyzing and problem-solving issues in a customer service setting
- 2+ years of experience with Long Term Disability claims processing (must have previous experience with initial eligibility reviews)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Keywords: UHG, UnitedHealth Group, Disability Claims Analyst, South Portland, ME