JOB REQUIREMENTS: At Northwestern Mutual, we are strong, innovative and growing. We invest in our people. We care and make a positive difference. Summary: Provides technical expertise for assigned product line(s) in the handling of complex, contestable, sensitive and large benefit amount claims. Primary Duties & Responsibilities: Responsible for providing technical expertise to applicable product line benefits division in the handling of complex, contestable, sensitive and large benefit amount claims. This includes responsibility for claims administration, compliance with applicable laws and regulations, ensuring claim handling standards/best practices and administration of claims in accordance with the company\'s claim philosophy. Uses extensive financial, medical, legal, claims and/or state requirement knowledge to provide technical assistance and direction to the staff in interpreting and analyzing pertinent facts associated with large dollar and contestable claims referrals by claims staff. Provides technical, consultation to staff to assist with their review of claims, appeals and complaints. Responsible for advanced training, case clinics, rounding, review of claim denials, appeals, depositions and claim settlements Provides prompt case review and initiates decisive action on claim approvals, denials and appeals of denied claims referred from the teams. Provides advice and direction on claims and where field investigation or negotiation is necessary and may be required to personally meet with the appropriate parties anywhere in the country to resolve the claim. Serves as a liaison with the Law Department, initiating and reviewing requests for legal opinions and assisting the staff in the application of legal opinions that are received. This may include assistance in preparing for ADR or litigation and gathering and presenting evidence and/or providing deposition or appearing as a court witness. Assists in the continued development of Claims Analysts, Specialists and Consultants by providing technical guidance, training, feedback, recognition and encouraging empowerment, aimed at enhancing their expertise in claims analysis. Proactively works to influence and motivate others while creating a climate that fosters customer focus and continuous learning and improvement. Participates in other departmental projects and in the department\'s management of assigned product line(s) claim unit. Develops, evaluates, and updates claim processes according to contract language and provisions, state statutes and regulations, and/or HIPAA requirements as applicable. Serves as product line subject matter expert for new contract introductions, regulatory routings and projects impacting claims handling. Qualifications: College degree or equivalent combination of education and experience five+ years\' experience working with medical and or claims/underwriting. In depth knowledge... For full info follow application link. EEO/AA Employer/Vets/Disability ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/38D4C743BE7E4128 Qualified females, minorities, and special disabled veterans and other veterans are encouraged to apply.