Job Description

General Purpose of Job

This position will perform and deliver on routine assignments/projects while simultaneously leveraging and applying knowledge of their assigned area(s) of responsibility. They will be responsible for the analysis and management of assigned claims. They will review, investigate, and make claim determinations regarding coverage, compensability, and appropriateness of claims.

Duties and Responsibilities

Analyzes and processes claims by investigating, gathering and obtaining information to make claim determinations.
Analyzes claimants coverage contracts to determine payment eligibility is met.
Collaborates with appropriate internal stakeholders to determine claim eligibility.
Conducts interviews with external stakeholders (e.g. physicians, claimants, and/or lawyers) on standard claims.
Evaluates and makes recommendations regarding claim eligibility determinations to management.
Identifies and communicates to management process improvements that reduce workloads or improve quality for his/her assigned area(s) of responsibility.
Maintains knowledge on current and emerging developments/trends for assigned area(s) of responsibility, assesses the impact, and collaborates with management to incorporate new trends and developments in current and future solutions.
Makes claim determinations.
Negotiates settlement of claims up to designated authority level and makes claims payments.
Performs and delivers on routine assignments/projects while simultaneously leveraging and applying knowledge of their assigned area(s) of responsibility.
Promotes and enhances organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.

Additional Position Responsibilities

Carries out duties in compliance with all state and federal regulations and guidelines. Complies with all company and site policies and procedures.
Makes a positive contribution as demonstrated by: - Making suggestions for improvement - Learning new skills, procedures and processes
Performs other duties as required.
Remains current in profession and industry trends.

Other Skills and Abilities

Ability to perform under stress in cases of emergency, critical or hazardous situations.
Ability to work with others in a team environment.
Demonstrated solid relationship management skills with internal clients (e.g. management, peers and colleagues).
Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.
Demonstrates solid project management skills including, critical ability to coordinate and balance multiple projects in a time-sensitive environment, under pressure, and meeting deadlines.
Demonstrates strong interpersonal skills with a collaborative style.
Demonstrates the ability to use sound judgment and discretion regarding confidential information.
Finds common ground and can gain collaboration among management, colleagues and peers; can influence outcomes without directing or commanding.
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
Successfully completes regulatory and job training requirements.

What's it like to work here?

At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

What’s in it for YOU:

A clearly defined career framework to help you successfully manage your career
Leadership development and virtual training opportunities
Paid Time Off
Parental leave
Competitive 401K and employee benefits
Free financial counseling, health coaching and employee assistance program
Tuition assistance program
A leadership team that prioritizes your health and well-being; offering a remote work environment
Effective productivity/technology tools and training

About the Company/Who is Lincoln Financial

Led by over 10,000 employees Lincoln Financial Group provides advice and solutions that help empower people to take charge of their financial lives with confidence and optimism. Today, more than 17 million customers trust our retirement, insurance and wealth protection expertise to help address their lifestyle, savings and income goals, as well as to guard against long-term care expenses. Lincoln is committed to creating a diverse and inclusive environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Education

4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelors)_Minimum Required in Business or Finance

Certifications

Experience

2-5+ Years Experience in claims that directly aligns with the specific responsibilities for this position (Required )