Senior Group Claim Consultant

Description:

WHAT YOU'LL DO:

• Has and/or acquires product knowledge in all areas of the business: Disability (STD/LTD), Life, Ancillary offerings, Dental, Vision, PFL and FML/Absence Management. With this knowledge, acts as a liaison for Claims and manages relationships with the Field, Brokers and clients to ensure the scope and quality of services are met.
• Delve into customer concerns and complaints regarding Claims and our entire range of products, providing complete ownership of the issue at hand for our Brokers and Clients. Take the lead in orchestrating and driving issue resolution from start to finish.
• You will provide high quality and thorough customer service and provides excellent service recovery, to include investigating service complaints and turning complaint/error situations into an advantage, owning the responses to questions and concerns while delivering service from a total need level and using every contact as an opportunity to provide a positive customer experience.
• Services and/or assists in servicing complex client issues and requests. When necessary, will partner with Claims and/or other internal business partners and create specific action plans for service recovery and improved customer satisfaction.
• Consult with regional managers, sales associates, internal business partners and external vendor partners to assist clients regarding insurance coverage needs and plan design. This includes but is not limited to pre/post sale communications, participation in sales meetings, and ongoing service needs.
• Proficient problem resolution skills. Identifies trends amongst the claim team and/or field offices and proposes recommended enhancements and/or solutions that can positively impact the customer experience.
• Involved in all aspects of customer life cycle: Pre-Sale, Implementation, Post Sale, Customer Education, Service Follow ups for both National Accounts and Core Customers for all WS Products and Vendors including LTD, STD, Life, LTC, VB, Vision, Dental, PFL, FML/Absence Management.

WHAT YOU’LL BRING:

• 2-5 years of direct group benefits claims experience (recent adjudication preferred), including expertise in claims management, adjudication, contract provisions, and the ability to communicate complex terms effectively. Proactive problem-solving for enhanced customer and broker claims experience.
• You've mastered the art of diplomacy, negotiation, and relationship-building. Every interaction is a chance to shine.
• Your ability to connect with others is second to none. You're not just a claims expert; you're a people person.
• You've proven your knack for providing top-notch customer service and ability to handle claim escalations. It's not just a skill; it's a commitment.
• Your communication and presentation skills aren't just good; they're excellent. You can present and articulate complex ideas and concepts effortlessly.
• You're not bound by existing barriers, methods, or practices. You're a visionary, pushing boundaries and exercising sound, independent judgment.
• Your team building and collaboration skills are your secret weapons. You know how to rally a team and work together effectively.
• You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
• Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.