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Individuals in this position are responsible for supporting the Financial Protection Claims Organization with regard to claims management oversight of the LTD claims team. They will effectively and professionally utilize sound judgment, technical knowledge, communication skills, and resources (Claims Organization, Claim’s processes and procedures, quality assessment tool, etc.) to meet the needs of the Financial Protection Organization. Additional responsibilities may include, but are not limited to:
Support and coach new and existing employees with their claim management practices, create consistency, and improve quality audit results; assist in promoting the use of appropriate tools / reference material (including policies & procedures, claim workflow documents, file documentation, clinical resources, financial resources and vendor options; identify trends and training needs and work with training department to ensure delivery to address needs; follow up with employees to ensure understanding of all training and new information provided to them; address and support the needs / requests of customers and account managers and ensure team is doing the same (lead by example); manage block of claims based on team needs; review reports and manage team by addressing outliers; act as backup to LTD Manager; complete other duties as identified by LTD Claims Manager.
- Demonstrate role model behavior regarding the core values of Integrity, Compassion, Relationships, Innovation, Performance
- Demonstrate a positive attitude
- Be accountable
- Consistently meet established productivity, schedule adherence, and quality standards
- Treat everyone with dignity and respect
- Demonstrate Open and Honest Communication – Approach the Claims Specialists (CS) to initiate a discussion when recommendations are outlined prior to finalizing a decision. Allow the CS the opportunity to amend/complete recommendations prior to pushing back the rehab / claim decision.
- Remain available / approachable – Encourage the CS to schedule time for claim discussions and promote critical thinking by active coaching and mentoring
- Understand UnitedHealth Group’s Pay For Performance culture
- Strong commitment to continuous learning and process improvement
- Adhere to appropriate response and turnaround times on all requests and deliverables
- Assessing customer needs and requirements, especially non - standard requests and problems, and respond or refer to appropriate resources
- Teach, coach / mentor, provide feedback and guide others
- Demonstrate ability in customer service issue resolution and relationship building
- Demonstrate solid understanding and comfort utilizing multiple computer systems / applications, including Microsoft Office products
- Work in a self - directed capacity with minimal guidance and seek guidance on only the most complex analyses
- Ability to make timely, confident decisions based on available data / facts
- Strong time management, organizational and prioritization skills and ability to balance multiple priorities
- Solid conflict resolution skills
- Ability to take direction; respond to requests and feedback
- Solid understanding of organizational structure; ability to facilitate issues through appropriate channels, including how and when to involve management
- Appropriately apply policies and procedures to ensure successful compliance with internal and external guidelines
- All other responsibilities as assigned by Management
- High School Diploma / GED
- 3+ years of Long Term Disability (LTD) Claims processing experience
- 1+ years of supervisory experience and / or claims knowledge / experience
- Previous experience working with Microsoft Office products - Word (ability to create, edit and save) - Outlook (ability to create, edit and save) and Excel (ability to create, edit and save)
- Solid communication skills, including the ability to listen objectively and articulate the facts of an issue verbally and in writing
- Ability to multitask and shift priorities quickly, professionally and positively to accommodate urgent tasks and to reach team, business area, and corporate goals
- Ability to
interact professionally with all internal and external customers,
including peers, members of management, members of other business
areas / segments, attorneys, etc.
- Demonstrate solid understanding and comfort utilizing multiple computer systems / applications
Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.SM
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, Long Term, Disability, LTD, South Portland, ME