• Benefits Review Specialist

    Location US-OR-Portland
    Posted Date 3 weeks ago(3 weeks ago)
    # Positions
    1
    Status
    Full-Time
    Req #
    17593
  • Overview

    If you want to make a positive difference and stand out from the crowd, you’ll fit in at The Standard (www.standard.com). Through our retirement plans and insurance products and services, we help people achieve financial well-being and peace of mind. Come join us and share our passion for serving our customers in a positively different way.

     

    Conduct independent reviews of disputed claims determinations; analyze Division claims administration;  make recommendations for improvement to contribute to appropriate benefit determinations, reserve accuracy and effective claim management.

    Responsibilities

    Contribute to the company’s success through excellent customer service and meeting or exceeding performance objectives for the following major job functions:

    • Conduct independent reviews of disputed claims decisions, and communicate decisions to claimants or their representatives, as well as to the appropriate Group Division personnel
    • Represent the company's claim decisions by giving depositions and testimony in litigation; work with Group Legal Department to clarify issues, prepare files for litigation, and resolve or settle disputed claims.
    • Assess specific benefits areas for compliance with procedures, claim management, performance standards and accuracy; identify areas of need and recommend methods for quality improvement based on assessment results and claim trends.
    • Communicate guidelines, regulations and claim/system procedures to division personnel; conduct studies on claim related issues, develop criteria and recommend procedures; serve as a division claim administration resource; assist in Benefits Department training.

    Qualifications

    Demonstrated skills:  Express ideas clearly in written and oral communication; communicate sensitive issues and unfavorable decisions to management and employees at various levels and external customers; be self-directed; plan and organize own work to meet changing priorities and deadlines.

     

    Ability to:  Analyze multiple, complex, legally sensitive claim issues and make accurate judgment calls; interpret decisions and contract provisions in litigious settings; apply knowledge of Benefits operations to assess claim administration quality; learn and retain changing procedures, methodology and legal issues related to claim administration; design and conduct quality assessments to meet department and division needs; report results and make recommendations for improvement; lead special studies, projects and conduct training to implement recommendations and improve results. 

     

    Working knowledge of:  ProClaim; ERISA guideline relating to group disability insurance.

     

    Advanced knowledge of:  Disability claim management principles.

     

    Education:  Degree in Business, Communications, or related field.

     

    Experience:  Three years experience as a Disability Benefits Analyst, or the equivalent combination of education and/or relevant experience.

     

    Professional certification:  FLMI or CEBS coursework and/or certification preferred.

     

     

     

    Standard Insurance Company, The Standard Life Insurance Company of New York, Standard Retirement Services, Inc., StanCorp Equities, Inc. and StanCorp Investment Advisers, Inc., marketed as The Standard, are Affirmative Action/Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, religion, color, sex, national origin, gender, sexual orientation, age, disability, or veteran status or any other condition protected by federal, state or local law. The Standard offers a drug and alcohol free work environment where possession, manufacture, transfer, offer, use of or being impaired by an illegal substance while on Standard property, or in other cases which the company believes might affect operations, safety or reputation of the company is prohibited. The Standard requires a criminal background investigation, drug test, employment, education and licensing verification as a condition of employment. All employees of The Standard must be bondable.

     

    For more information regarding your Equal Employment Opportunity applicant rights, click  here.

     

    Individuals with disabilities who need assistance or accommodation with the application process should contact HR Direct at 971-321-7871.  This number is only for the use of individuals with disabilities who need accommodation with the application process.  General inquiries about application status will not be addressed.

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