at Lincoln Financial Group in Springfield, Illinois, United States
Job Description
Alternate Locations: US All Regions; US Midwest; US Northeast; US Southeast; US Southwest; US West; Work from Home
Work Arrangement:
Remote : Work at home employee residing outside of a commutable distance to an office location.
Relocation assistance: is not available for this opportunity.
Requisition #: 72964
The Role at a Glance
We are excited to bring on an Appeals Specialist to join our Appeal Review Department in a fully remote environment. Appeal Specialists conduct reviews, investigation, and analysis of an assigned caseload of Short-Term Disability appeals. The role is responsible for interpreting and applying correct contract terms/provisions, ERISA requirements, statutory guidelines, and case management and appeal procedures to each claim.
Background Details
As an Appeals Specialist you will be responsible for being a product subject matter expert to provide full, fair appeal reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will analyze and manage a caseload of appeals claims. You will review, investigate, and make claim determinations regarding coverage, compensability, and appropriateness of
claims. You will provide technical information and detailed guidance to Claims management & teams regarding products, claims processes, regulations, and applicable systems for their assigned claims area. If this sounds like a role for you, please read on!
What you’ll be doing
+ You will analyze & process claims by investigating & obtaining a wide range of complex information. Apply claim policies & procedures and engages intervention of internal/external resources to ensure fair, ethical, & timely management of assigned claims.
+ You will analyze and interpret complex coverage contracts to determine if eligibility is met.
+ You will identify, interpret, and resolve gaps in financial calculations and offsets when applicable, share technical knowledge and approach on financial calculations with team members that involve complex contract provisions.
+ You will research questions and escalations from Claims team; liaises with various stakeholders from across the business (Underwriting, Actuarial, Compliance, Account Management, etc.) to obtain needed information to clarify and address issues.
+ You will provide customers with in-depth explanations of policy details, claim process, and claim determination; ensure parties understand the information and outcome.
+ You will utilize internal reporting to identify trends and review/audit performance against team metrics; propose and develop practices & processes to improve performance and the customer experience.
+ You will effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims workflow. Provide detailed guidance & coaching to junior team members.
What we’re looking for
Must-have:
+ 4 Year/Bachelor’s degree or equivalent work experience (4 years of experience in lieu of Bachelor’s)
+ 1 – 3+ Years of Short-Term and/or Long-Term Disability. (Required)
+ Ability to communicate effectively (verbal/written)
+ Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
Nice-to have:
+ Experience working with multiple products.
+ Presentation training or skills
+ Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.
+ SystemOne experience
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:
+ Clearly defined career tracks and levels to help you successfully manage your career
+ Leadership development and virtual training opportunities
+ PTO/parental leave
+ Competitive 401K and employee benefits (https://hrdirectdocs.lfg.com/misc/HR/Recruiting/BenefitsResourcesGuide.pdf)
+ 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 and flexible work hybrid situations
+ Effective productivity/technology tools and training
Pay Range: $53,500 – $92,500
Actual base pay could vary based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.
About The Company
Lincoln Financial Group helps people to plan, protect and retire with confidence. As of Dec. 31, 2023, approximately 17 million customers trust our guidance and solutions across four core businesses – annuities, life insurance, group protection and retirement plan services. As of December 31, 2023, the company had $295 billion in end-of-period account balances, net of reinsurance. Headquartered in Radnor, Pa., Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. Learn more at LincolnFinancial.com.
Lincoln is committed to creating a diverse and inclusive (https://www.lfg.com/public/aboutus/companyoverview/diversityinclusion?audience\page\id=1422918942386) 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.
Follow us on Facebook (http://www.facebook.com/lincolnfinancialgroup) , X (https://mobile.twitter.com/lincolnfingroup) , LinkedIn (https://www.linkedin.com/company/4307?trkInfo=tas%3Alincoln+financial%2Cidx%3A3-1-3&trk=tyah) , and Instagram (https://www.instagram.com/lincolnfingroup/) . For the latest company news, visit our newsroom (https://www.lincolnfinancial.com/public/aboutus/newsroom) .
Be Aware of Fraudulent Recruiting Activities
If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.
Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln’s fraud team at fraudhotline@lfg.com if you encounter a recruiter or see a job opportunity that seems suspicious.
Additional Information
This position may be subject to Lincoln’s P
