6 Claims Processors jobs in Des Moines

The **Absence Case Management** **Team Leader** leads a team of Absence Management Case Managers to get results within their team and the organization. As the team lead you will support team members, guide goal achievement, present progress updates and ensure meeting standards. The Team Leader also assists staff with career development and progression while encouraging candor while challenging the status quo to improve the way we work. You will partner with internal cross functional areas for program direction, goal setting, service delivery and development of action plans and using bench strength.
In addition, the Team Leader will validate that all FML, STD, State, and PFL are accurately adjudicated according to plan provisions, established standard methodologies and within state and federal guidelines. The Team Leader will run and resolve issues that pertain to claim administration procedures, cost containment activities, reports, quality control and complex customer issues. The Team Leader will work with external customers/clients to enhance the overall experience for the customer while facilitating the overall functioning of the team then you will present to leadership on team status and performance.
You will
+ Partner with leadership to develop and communicate objectives and performance goals for the team.
+ Lead direct report performance by coordinating with HR to implement coaching plans and performance improvement plans.
+ Develop employee goals to promote career growth that enhance level of knowledge for future opportunities.
+ Collaborate with internal business partners including Short Term Disability, Long Term Disability, Service, Sales and Account Management, Group Quality Management, and other areas within the Company.
+ Create regular action plans based on results from employee engagement surveys - the Team Leader owns and acts on engagement survey results.
+ Review and analyze daily, weekly, and monthly reports on team productivity 1) for operational reporting and monitoring purposes; 2) to identify trends and training opportunities; and 3) to create action plans for improvement.
+ Review processes/reports regularly for process improvement opportunities.
+ Own relationship with client and get involved, when necessary, in meetings, phone calls, and keeping a tight loop on service issues.
+ Prioritize the customer/client experience in day-to-day interactions and processes.
+ Identify Continuous Improvement opportunities by reviewing process and eliminating unnecessary steps.
+ Empower staff to submit process improvement ideas to revise workflows and procedures.
+ Support claims initiatives by encouraging/providing relevant feedback and being an effective change leader for project rollouts.
+ Schedule and facilitate team meetings and individual touchpoints.
+ Mentor, coach, lead and develop talent by acting as a partner in recommending and coordinating training resources, tools, and plans for individuals to achieve personal and departmental goals and objectives.
+ Review claim staff QA/CMA assessments for training or enhancement opportunities.
+ Use data and analytics to improve or change business process.
You have
+ Bachelor's degree in related field and/or equivalent relevant disability work experience; integrated absence management preferred.
+ 3+ years of disability claims experience.
+ 3+ years of demonstrated leadership experience.
+ Extensive knowledge of disability products, business rules and procedures.
+ Familiarity with mandated state and federal regulations.
+ Professional oral, written and presentation skills.
+ Validated organizational and time management skills.
+ Excellent math proficiency and analytical skills.
+ Strong PC skills, including Microsoft Office applications.
Leadership Behaviors
Team Leadership
+ Hire, develop and retain top talent. Recognize and reward team members. Model leadership behavior and act as a servant leader to ensure team success. Communicate effectively with team, champion, and challenge changes with positivity. Own messaging and decision making. Lead team through ambiguity.
Problem Solving
+ Be creative and take calculated risks to achieve goals and results. Make mistakes and learn quickly from them, model this behavior for your team.
Customer/Client Focused
+ Act with vitality and ownership to resolve customer issues. Proactively identify and resolve issues when possible. Work to ensure self and team prioritize the customer experience.
Results Focused
+ Drive team to achieve results, focusing on desired outcomes. Action plan for team management despite operational challenges.
LOCATION
This is a remote position with preference given to candidates in close proximity to a Guardian office with minimal travel to other locations and conferences.
**Salary Range:**
$57,330.00 - $94,185.00
The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
**Our Promise**
At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
**Inspire Well-Being**
As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at . _Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits._
**Equal Employment Opportunity**
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
**Accommodations**
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact .
**Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.**
Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being - mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com .

Description:

We are looking for individuals to participate in National & Local Paid Focus Groups, Clinical Trials, and Phone Interviews. This is a great opportunity to earn extra income from the comfort of your home by sharing your opinions on various topics such as child-related issues, cell phones, entertainment, food, sports, electronics, pets, and automobiles. The responsibilities include participating in discussions, completing written surveys, and using products or services provided for feedback.

Requirements:

• Must have a smartphone with a working camera or a desktop/laptop with a webcam
• Reliable internet connection
• Desire to fully participate in one or several of the above topics
• Ability to follow instructions

Benefits:

• Flexibility to work remotely
• No minimum hours
• Opportunity to review and use new products or services before they are launched publicly
• Compensation ranges from $75 to $50 per 1-hour session and 300 to 750 for multi-session studies

Educational Requirements:

• High school diploma or equivalent

If you are looking for a flexible part-time remote work opportunity with no previous experience needed, this is the perfect position for you.

SYNERGISTICIT is aware that the Job Market is Challenging due to almost 600,000 Tech Layoffs within the past 2 years due to which The Job market is flooded with thousands of laid off Techies who are competing with existing Jobseekers. For entry level Job seekers to get client interviews and jobs they need to differentiate themselves by ensuring they have exceptional skills and technologies to be noticed by clients.

Since 2010 we have helped Jobseekers differentiate themselves by providing the clients with candidates who have the requisite skills and experience to outperform at interviews and clients. Here at SynergisticIT We just don't focus on getting you a Job we make careers.
All Positions are open for all visas and US citizens
We are matchmakers we provide clients with candidates who can perform from day 1 of starting work. In this economy no client wants or has the resources to take an entry level person and spend resources on upgrading their skills and on top of that pay the jobseeker. That's the specific reason there are so many techies both experience and freshers who are unemployed.
Clients have now the option to hire remote workers from anywhere so for a Jobseeker its important to introspect and see how they can become better and have the skills and technologies to meet client requirements.
We at Synergisticit understand the problem of the mismatch between employer's requirements and Employee skills and that's why since 2010 we have helped thousands of candidates get jobs at technology clients like apple, google, Paypal, western union, Client, visa, walmart lab s etc to name a few.
Who Should Apply Recent Computer science/Engineering /Mathematics/Statistics or Science Graduates looking to make their careers in IT Industry
We welcome candidates with all visas and citizens to apply.
If you get emails from our skill enhancement team please ask them to take you off their distribution list and make you unavailable as they share the same database with the client servicing team.

please check the below links to see success outcomes of our candidates
Synergisticit Pics /Salaries of Successful Candidates

Synergisticit at Oracle Cloudworld 2023

Synergisticit at Gartner Data & Analytics summit

Why do Tech Companies not Hire recent Computer Science Graduates | SynergisticIT

Technical Skills or Experience? | Which one is important to get a Job? | SynergisticIT

If you have relevant skills and industry experience, please apply
For preparing for interviews please visit

REQUIRED SKILLS For Java /Software Programmers

• Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT
• Highly motivated, self-learner, and technically inquisitive
• Experience in programming language Java and understanding of the software development life cycle
• Project work on the skills
• Knowledge of Core Java , javascript , C++ or software programming
• Spring boot, Microservices, Docker, Jenkins and REST API's experience
• Excellent written and verbal communication skills

For data Science/Machine learning
REQUIRED SKILLS

• Bachelors degree or Masters degree in Computer Science, Computer Engineering, Electrical Engineering, Information Systems, IT
• Project work on the technologies needed
• Highly motivated, self-learner, and technically inquisitive
• Experience in programming language Java and understanding of the software development life cycle
• Knowledge of Statistics, SAS, Python, Computer Vision, data visualization tools
• Excellent written and verbal communication skills

Preferred skills: NLP, Text mining, Tableau, PowerBI, Time series analysis
Please understand skills and relevant experience on real world projects are required by clients for selection even if its Junior or entry level position the additional skills and Project work with hands on experience building projects at client site are the only way a candidate can be picked by clients.
No third party candidates or c2c candidates

please only apply to the posting
If you get emails from our skill enhancement team please ask them to take you off their distribution list and make you unavailable as they share the same database with the client servicing team.

No phone calls please. Shortlisted candidates would be reached out.

The **Behavioral Health Clinical Consultant** serves as a clinical resource for the investigation and assessment of medical information regarding disability by providing comprehensive medical reviews and analysis of long-term and or short-term disability claims. The Behavioral Health Clinical Consultant identifies restrictions, limitations and duration impacting functional capacity based on medical data, to assist the Case Managers in determining claim liability. The Behavioral Health Clinical Consultant collaborates with treating providers to assist individuals to obtain appropriate care and ensure optimal treatment outcomes and acts with urgency and ownership to resolve customer issues and prioritize the customer experience.
**You are:**
A highly motivated and reliable individual who can work with varying levels of supervision- independently or collaboratively. You are detail-oriented and a decisive decision maker who can manage multiple priorities at the same time.
**You have**
+ A minimum of 5 years in direct patient care settings
+ BSN with strong Behavioral Health background preferred. Will consider LCSW or other licensed Behavioral Health professional with disability experience.
+ Excellent verbal and written communication skills and presentation skills
+ Ability to exercise independent & sound judgment in decision making
+ Strong problem-solving, analytical, clinical, and information research skills
+ Excellent time management & organizational skills
+ Demonstrated ability to multi-task with the ability to manage continually changing priorities and the ability to prioritize work based on customer service needs and departmental regulations
+ The ability to remain flexible due to changing business needs
+ Strong knowledge of medical conditions and how they apply to disability products
+ Professional oral, written and presentation skills
+ Strong PC skills, including Microsoft Office applications (MS Word, Excel, PowerPoint)
+ Knowledge of disability products, business rules and procedures, preferred
+ Experience with DCMS, Claim Facts, and iProcess preferred
+ Disability experience strongly preferred
**You will**
+ Review long-term and or short-term disability claims to assess the impact of claimants' medical condition on their function as well as the impact of their medical treatment in achieving improved functional outcomes.
+ Possess a strong clinical background to understand and apply rationale of how injury or illness may impact the individual's function.
+ Possess excellent verbal and written communication skills to gather and report information accurately, ask appropriate questions to facilitate partnership with treating providers, claimants, and internal partners to encourage participation of claimant in appropriate treatment goals.
+ Conduct analysis of claimant's current treatment plan and collaborate with health care providers and claimants to promote accountability for the appropriateness and status of treatment plan and length of disability.
+ Proactively contact treating providers to discuss treatment plans and clarify treatment and RTW goals. Educate providers and claimants on the positive impact of return to work to ensure improved functional status and medical outcomes.
+ Serve as a technical resource on the medical aspect of long-term and or short-term disability claims.
+ Identify opportunities to educate claim staff and peers on medical aspect of disability.
+ Provide ongoing training and mentoring to claims staff and peers regarding issues impacted by the nature of injury or illness and its impact on function in work or daily activities.
+ Work collaboratively with internal vocational rehab specialists in identifying opportunities for return to work.
+ Work to proactively identify and resolve customer issues, when possible, to enhance the customer experience.
+ Utilize independent vendors to perform independent medical assessments. Specifically define issues to be addressed or clarified by outside physician or provider and oversee quality of review.
+ Manage workflow efficiently, organize priorities, provide timely intervention, and implement continuous quality process improvement.
**Location**
+ This role is remote with occasional in office meetings as required by the people leaders.
**Salary Range:**
$67,450.00 - $110,815.00
The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
**Our Promise**
At Guardian, you'll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
**Inspire Well-Being**
As part of Guardian's Purpose - to inspire well-being - we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at . _Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits._
**Equal Employment Opportunity**
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
**Accommodations**
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact .
**Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.**
Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being - mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com .