• Claims Specialist

    Lincoln Financial Group{"Country":"US","IsEmpty":false}

    Job #1781407733

  • Alternate Locations: Work from Home (Excluding Colorado)

    Work Arrangement: Work from Home

    Relocation assistance is not available for this opportunity.

    Level: N3-1

    Requisition #: 67167

    About The Company

    Lincoln Financial Group, a Fortune 250 company with over 10,000 employees, provides advice and solutions that help empower Americans to take charge of their financial lives with confidence. Our core business areas - Life Insurance, Annuities, Retirement Plan Services and Group Protection - focus on supporting, preserving and enhancing over 17 million customer's lifestyles and retirement outcomes.

    Headquartered in Radnor, Pennsylvania, Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. The company had $238 billion in assets under management as of December 31, 2018.

    Ranked one of the Best Large Employers in America by Forbes magazine, Lincoln Financial Group makes a serious investment in our employees' futures through a broad range of wealth accumulation and protection plans, health and wellness programs, and career development resources designed to help each individual reach their personal and professional goals.

    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 ~~~ if you encounter a recruiter or see a job opportunity that seems suspicious.

    General Purpose of Job

    This position will perform and deliver on routine and non-routine assignments for their assigned claims area(s) independently in accordance with established procedures / guidelines. They will process increasingly complex claims ensuring the fair, ethical and timely processing of assigned claims.

    Duties and Responsibilities

    Applies expanded knowledge obtained from the role in increasingly more complex situations and continues to acquire more knowledge to apply in role.

    Conducts initial and ongoing claimant interviews and appropriately updates claim file/documentation.

    Delivers routine work independently, in accordance with established procedures and guidelines, in a timely manner and meets deadlines appropriately.

    Ensures the accuracy and completeness of submitted claims.

    Escalates claims issues/concerns to senior team members and/or management.

    Focuses claim activities on managing claim duration and financial liability as per contractual provisions, while ensuring compliance with applicable regulations & company policies.

    Follows processes for consistent case management, including creation and maintenance of action plans that outline timing of follow-up activities and key decisions to effectively administer policy provisions.

    Identifies and applies special handling provisions

    Identifies benefit discrepancies and completes more complex adjustments as needed.

    Makes routine & non-routine decisions, applying limited but increasingly more discretion within role except for matters of significance which affect the business as a whole or a significant part of it, in accordance with established procedures & guidelines

    Meets or exceeds departmental quality and service standards.

    Obtains increasingly complex information needed (e.g. financial and medical records, etc.) to make claim determinations and accurately calculate more complex benefits, seeks second-level review as needed.

    Provides a diverse range of information and performs a diverse range of tasks/transactions related to common programs and services.

    Provides customer service to internal and/or external stakeholders, recognizes what needs to be done to meet customer needs and demonstrates flexibility and responsiveness to meet customer needs on routine work independently.

    Provides responses and a diverse range of information to junior team members' questions to support organizational capabilities.

    Recognizes issues or concerns for assigned area(s) of responsibility, explains effect on the customer's service experience, and suggests process improvements.

    Reviews increasingly complex medical records/information and effectively leverages a variety of internal/external tools & resources to understand medical terminology, duration, functionality, documentation, organization, and overall claims workflow.

    Reviews increasingly complex submitted claim information for payment.

    Supports and promotes change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.

    With limited supervision, interprets increasingly complex policy provisions to assess eligibility and render claims decisions based on contractual definitions. Processes more complex claims, seeking appropriate resources as needed.

    Works overtime as needed.

    Additional Position Responsibilities

    Carries out duties in compliance with all state and federal regulations and guidelines. Complies with all company and site policies and procedures.

    Makes a positive contribution as demonstrated by: - Making suggestions for improvement - Learning new skills, procedures and processes

    Performs other duties as required.

    Remains current in profession and industry trends.

    Other Skills and Abilities

    Ability to perform under stress in cases of emergency, critical or hazardous situations.

    Ability to work with others in a team environment.

    Demonstrated solid relationship management skills with internal and/or external clients (e.g. management, peers, colleagues, customers, etc.).

    Demonstrates ability to work in a fast-paced environment.

    Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.

    Demonstrates strong interpersonal skills with a collaborative style.

    Demonstrates the ability to use sound judgment and discretion regarding confidential information.

    Finds common ground and can gain collaboration among management, colleagues and peers.

    Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

    Successfully completes regulatory and job training requirements.


    High School or GED - Minimum Required



    2 - 3 Years of claims experience directly aligned to the specific responsibilities for this position (Required )

    Work Arrangement:

    Work from Home : Employees will work fully from home. Their job will not require the employee to come into the office, unless for special circumstances.

    This position may be subject to Lincoln's Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln's current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

    Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.

    Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling ~~~.


    Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.