Sr. Claim Consultant

BRIEF DESCRIPTION

As a member of the Life & Disability group, the Senior Claim Consultant is responsible for assisting with the planning and set up of claim audits. This position will function as a claim auditor assisting clients with identifying issues impacting client claims experience in addition to being an intermediary problem solver between client and vendor.

ESSENTIAL DUTIES AND RESPONSIBILITIES include, but are not limited, to the following:

• Pre-audit planning to understand audit scope, identification of audit resources and logistics for onsite and virtual audits

• Understanding of end to end process to ensure audit questions align with standard and customized claim procedures

• Development of audit questions and audit tools to be used during the audit

• Data analysis and claim selections

• Creation of Quick Reference Guides to be used by auditors during each audit

• Analyze audit results and assist in the creation of the audit report identifying issues and recommendations for improvement

• Participate in the delivery of audit findings to client

• Work with Account Managers on identifying and problem solving claim issues between clients and their vendors or in-house leave administration groups

• Represent ADL as a subject matter expert on claim administration processes and best practices

This position is not available for remote work from Colorado

REQUIRED EDUCATION AND EXPERIENCE**:**

• Minimum of 5+ years in a disability claim experience with a TPA or insurer

• Proven experience managing leaves, STD and LTD (WC experience is highly preferred)

• Experience managing a claim team or acting as an intermediary between claim teams andclients (specifically assisting with onboarding new clients, customized processes, training of claim teams and problem solving) desired.

• Solid understanding of federal and state leave laws and ADA

• Ability to travel up to 40% post-COVID

KNOWLEDGE, SKILLS AND ABILITIES

• Client facing with strong presentation skills

• Deep technical claim model acumen

• Proven ability to build rapport while providing superior client service and maintaining positive relationships with internal teams and client contacts;

• Strong organizational and management skills with strong attention to detail and follow-through;

• Excellent analytical, problem solving, risk management, and decision making skills;

• Possess proactive mindset to seeks information to create effective solutions;

• Must be able to effectively interact with people at all levels inside and outside of the company

PHYSICAL DEMANDS AND WORK ENVIRONMENT

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is:

  • Frequently required to sit; speak or hear; use hands to finger, handle, feel objects, and reach with hands and arms;

  • Occasionally required to stand and walk;

  • Extensive use of computer and keyboard and viewing of computer screen is required;

  • Specific vision abilities required by this job include vision, and ability to adjust focus.

• Other working conditions are normal for an office environment.

WORK LOCATION

• Work is typically performed either on site at the Conshohocken office, or at various customer/Trion locations as required.

We embrace a culture that celebrates and promotes the many backgrounds, heritages and perspectives of our colleagues and clients. Marsh & McLennan Agency offers competitive salaries and comprehensive benefits and programs including: health and welfare, tuition assistance, 401K, employee assistance program, domestic partnership benefits, career mobility, employee network groups, volunteer opportunities, and other programs. For more information about our company, please visit us at: http://marshmma.com/careers.