Disability Insurance Blog

Your Career as an LTD Benefits Manager


Wednesday, December 3rd, 2014

We love Craigslist, especially when Long Term Disability insurance companies post job openings. What does it mean to work as a claims benefit manager at an LTD company?

…. to ensure prompt and accurate payment and liability management of moderately complex disability claims.

Based on our experience, ensuring prompt and accurate payment is not exactly the top of the list, either for the company or the benefit manager. But it gets better.

Works with attorneys and insurance carriers regarding 3rd party litigation and/or subrogation issues. Effectively utilizes risk management tools to determine appropriate length of certification and timing of referrals for other income offset opportunities, Consults and reviews clinical information with nurses and Medical Directors to establish the appropriate length of certification given contractual provisions and regulatory requirements.

It sounds so straightforward. Read the contract, work with attorneys, doctors, nurses and determine how long benefits need to be paid. But “timing of referrals for other income offset opportunities” confuses us. Does that mean referrals to Social Security to file a claim so that there’s an offset? Or timing referrals to doctors who will deny their claims?

Working as a claims benefit manager for any of the LTD insurance companies is a challenging position. The requirements to be hired are not that difficult to meet – one to three years of experience and some working knowledge of ERISA, ADA, along with some state, federal and local regulations about claim investigation, disability decisions, claims payment, tax and reporting requirements. You don’t need a Masters Degree in Public Policy – any Bachelor’s Degree seems to be acceptable.

But once you are hired, we wonder, how easy is this position? You must answer to two bosses- the insurance company and your conscience. How many calls does a benefit manager get from people who are facing foreclosure, whose benefits are being cut off and whose illness has them unable to function, before they start treating these calls with a cold analytic mindset?

We wonder about what happens to a person who spends their days sifting through an overwhelming number of calls and letters and managing a huge caseload of claims files. Maybe they develop a sort of radar ability that allows them to distinguish the difference between a truly ill person and a malingerer? Based on the number of calls that our practice gets on a daily basis, we think not.

If you are inclined to go looking for jobs on Craigslist, and that includes becoming a Long Term Disability insurance company benefits manager, we think it’s wise to consider the potential side effects that come with having this kind of responsibility. Will you be able to maintain an objective position when you evaluate claims, listen with open ears to our clients when they call because they don’t understand why their claim has been denied, and read their medical records in their entirety, instead of looking for clues of deception where none exist?

If your claim has been denied or is being delayed by a benefit manager who you suspect has become hard-hearted, call our office at 877-LTD-CLAIM (877-583-2524).