DI Claims Specialist

Wisconsin, United States

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$57,470 – $111,540Compensation

Junior (1 to 2 years), Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Insurance, Financial ServicesIndustries

Requirements

Candidates should possess a Bachelor's degree or equivalent work experience, with 1-3 years of relevant experience demonstrating analytical ability, independent decision-making, and sound judgment in applying guidelines. Strong organizational and communication skills, particularly written communication, are essential, along with the ability to collaborate effectively within and across teams.

Responsibilities

The DI Claims Specialist will determine benefit applicability by interpreting contract provisions and maintaining consistency with the company's disability benefits claim philosophy. This role involves ordering and reviewing medical, financial, and investigative information to assess claim eligibility, actively managing a caseload of pending and active claim files, and making decisions regarding claim approval, denial, continuation, and termination. Responsibilities also include communicating with insureds, field representatives, medical practitioners, attorneys, other insurance companies, financial advisors, employers, and governmental agencies, which may involve negotiation and conflict resolution. The specialist may represent the company in legal matters, including depositions and trials, and is responsible for preserving the company's image and reputation in benefit decisions.

Skills

Disability Claims Administration

Contract Interpretation

Medical Records Review

Financial Records Review

Claim Evaluation

Decision Making

Communication

Negotiation

Conflict Resolution

Analytical Ability

Independent Decision-Making

Judgment

Collaboration

Organization

Written Communication

Northwestern Mutual

Provides financial security services, and wealth management

About Northwestern Mutual

Northwestern Mutual offers personalized financial planning, life insurance, and investment services, leveraging leading-edge technology to manage over $125 billion in client assets for more than 4.5 million clients.

Milwaukee, WisconsinHeadquarters

1856Year Founded

N/ACompany Stage

Consulting, Fintech, Financial ServicesIndustries

10,001+Employees

Benefits

Growing your Career

Compensation & Time Off

Insurance plans

Health Savings Account

Wellness programs & resources

401(k) plan and cash balance contributions

Risks

Fintech platforms like Carefull challenge traditional financial advisory services.

Internal competition may arise from Wellthi's focus on the Black community.

Customer dissatisfaction may grow due to increased retirement age expectations.

Differentiation

Northwestern Mutual maintains the highest financial strength ratings in the industry.

The company launched 'The Great Realization' campaign to refocus customer priorities.

Northwestern Mutual offers a unique Long-Term Advantage product with life insurance benefits.

Upsides

The aging population increases demand for retirement planning and long-term care solutions.

Partnerships with tech firms enhance Northwestern Mutual's data analytics capabilities.

Digital transformation in insurance leads to more personalized customer experiences.

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