Customer Experience Advocate - Disability (Finance)

The Customer Experience Advocate provides exceptional customer service to clients and their employees by handling calls in a timely, accurate, and professional manner. This role is responsible for one contact resolution for any issues reported via phone or email.

• High School diploma.
• Two years of years of STD/LTD claims adjudication experience.
• Experienced in the TPA or self-administration services preferred.
• Experience with FMLA/State leave claims preferred.
• Ability to learn medical terminology and conditions.
• Ability to interpret procedures and regulations.
• Knowledgeable in Excel, Word, and web-based systems.
• Excellent verbal and written communication skills.
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures.
• Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
• Strong ability to identify, analyze and solve problems.
• Effective interpersonal skills capable of dealing with external sources and all levels of employees.

• Responsible for pilot line calls and email communications resulting in reactionary responses within the claim.
• Manages and authorizes payment on claims while meeting all service, timeframe, and productions standards.
• Communicates with claimants, employers, and medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of benefits.
• Applies the appropriate contractual provisions, case management resources, and claim processes to ensure eligibility requirements and liability decisions are accurate.
• Responsible for de-escalating calls submitted by Absence Specialists.
• Responsible for providing excellent customer service and industry knowledge to inquiries.
• Assists in the training of new employees as needed.
• Performs other duties as assigned.
• Upholds the Crawford Code of Conduct.