PLADS Sr Life Case Manager

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a PLADS Sr Life Case Manager based in the United States.

In this role, you will be responsible for managing complex life and disability claims with a high level of accuracy, empathy, and regulatory compliance. You will evaluate medical, legal, and financial documentation to determine eligibility and ensure timely, fair, and well-supported claim decisions. The position requires strong analytical judgment and the ability to navigate sensitive customer situations with professionalism and care. You will act as a key point of contact for claimants, providing clear communication and ensuring a supportive experience throughout the claims lifecycle. Working in a structured yet fast-paced environment, you will collaborate closely with internal teams to maintain operational excellence and compliance standards. This role is well suited for someone who combines technical claims expertise with strong customer service and attention to detail.

• Evaluate and process life and accident claims by reviewing medical, legal, financial, and policy-related documentation to ensure accurate and timely decisions aligned with contractual and regulatory requirements.
• Maintain detailed and compliant documentation of all claim activities, ensuring accurate updates within claims management systems and adherence to operational standards.
• Develop and execute structured claims management plans, ensuring efficient resolution while meeting or exceeding performance and quality metrics.
• Communicate with claimants, employers, and internal partners in a professional, empathetic, and customer-focused manner to build trust and support positive outcomes.
• Collaborate with internal teams to resolve complex claim issues, support workflow efficiency, and contribute to continuous improvement initiatives.
• Provide mentorship and support to newer team members while participating in team projects and initiatives aimed at improving claims operations.

Requirements:

• High school diploma or equivalent required; bachelor’s degree in a related field preferred.
• 3–5 years of experience in life insurance, disability claims, or a related claims management environment.
• Strong understanding of medical terminology, anatomy, pathology, and insurance policy interpretation.
• Solid knowledge of claims management principles, regulatory requirements, and industry best practices.
• Strong written and verbal communication skills with the ability to make sound decisions and manage sensitive information.
• High attention to detail, strong organizational skills, and ability to manage multiple priorities in a structured environment.
• Proficiency with Microsoft Office and claims or enterprise software systems, with the ability to learn new tools quickly.

Benefits:

• Competitive salary range of $65,000 to $85,000 based on experience and qualifications.
• Comprehensive health benefits including medical, dental, vision, and prescription coverage.
• Retirement savings plan with 401(k) options and potential employer contributions.
• Paid time off including holidays, vacation days, and additional leave programs.
• Supplemental insurance options including accident, critical illness, and hospital indemnity coverage.
• Flexible remote work arrangement within the continental United States.
• Opportunities for professional development, mentorship, and career growth within a structured organization.