Senior Group Claim Consultant

Location: Remote

Work Type: Full Time Regular

Job No: 505004

Categories: Claims/Claims Processing

Final date to receive applications: Open Until Filled

We are hiring a Group Claims Consultant in our Workplace Solutions division. You will play a critical role in the growth and persistency of Group Claims by collaborating with and acting as a liaison between the Claims organization and Sales/Brokers while providing responsive, comprehensive service and solutions through email and phone calls (proactive or otherwise). You will develop and maintain relationships at varying levels to include front line employees, team leaders, senior leadership, sales and brokers.

The impact you will make in this role will be based on the strength of these relationships and an ability to utilize independent judgement, critical thinking and solution‑oriented creativity to meet the clients needs.

• Group Claims Consultant: $60,000 - $70,000, plus annual bonus opportunity
• Senior Group Claims Consultant: $75,000 - $80,000 plus annual bonus opportunity

• 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.
• Provide high quality and thorough customer service and excellent service recovery, 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, 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 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.

• 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.
• Diplomacy, negotiation, and relationship‑building skills. Every interaction is a chance to shine.
• Strong communication and presentation skills. Able to present and articulate complex ideas and concepts effortlessly.
• Visionary, pushing boundaries and exercising sound, independent judgment.
• Team building and collaboration skills. Able to rally a team and work together effectively.
• Promotes a culture of diversity and inclusion, values different ideas and opinions, and listens courageously, remaining curious.
• Remote work capability with a high-speed internet connection. Located in the United States or Puerto Rico.

• Experience with STD, Paid Family Leave or Statutory Leave programs

We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements, please apply!