Lori Coleman
Dover,NH
Summary
Results-driven long-term disability claims professional with over 15 years of experience in adjudicating complex LTD, life, and workers' compensation claims. Expertise in regulatory compliance, claims investigation, settlement negotiation, and thorough review of medical and legal documentation. Proven track record of managing high-volume caseloads while consistently meeting rigorous performance metrics. Committed to operational excellence through training, mentorship, and process improvement, while delivering exceptional customer service.
Overview
16
16
years of professional experience
Work History
Long Term Disability Case Manager
Lincoln Financial Group
01.2015 - Current
- Analyze and adjudicate claims to establish coverage, liability, and compensation eligibility. Forge collaborative relationships with internal stakeholders to validate claims. Execute comprehensive interviews with external parties, such as physicians and lawyers, to gather insights on intricate claims. Strategically negotiate and authorize settlements for advanced claims, managing payment disbursements. Uphold stringent daily and monthly performance targets, delivering superior customer service consistently.
- Oversaw and resolved over 2K+ complex long-term disability claims for commercial insurance products
- Conduct comprehensive interviews with physicians, attorneys, and claimants to obtain medical and legal information required for accurate claim determinations.
- Aligned the creation and deployment of new hire training manual, enhancing training process and operational efficiency.
- Led educational workshops for other long-term disability teams, reinforcing critical knowledge and team readiness.
- Directed the full lifecycle of LTD claims, ensuring compliance with policy terms, legal standards, and internal guidelines.
- Collaborated with Waiver of Premium/Death, Settlement, and Recertification teams to evaluate claims, coordinate case strategies, and expedite closing of claims.
- Streamlined cross-team workflows, reducing claim processing time while maintaining high claimant satisfaction.
Short Term Disability/FMLA Specialist
Liberty Mutual Insurance
01.2010 - 01.2015
- Managed comprehensive family medical leave processes, applying in-depth knowledge of federal and state regulations to ensure accurate leave decisions. Processed and verified leave-related documentation with high precision, maintaining compliance with operational standards.
- Addressed and resolved complex leave-related inquiries, providing exemplary customer service to enhance client satisfaction.
- Mentored new department hires, facilitating smoother transition and faster acclimation to departmental procedures.
- Managed cases for high-profile clients, consistently providing tailored, attentive service.
- Led cross-functional teams to streamline communication and collaboration across departments.
- Improved customer satisfaction rates through proactive problem-solving and efficient complaint resolution.
Education
Bachelor of Science in Business Administration - Marketing
Vermont State University
Castleton, VTSkills
- Claims Adjudication
- Regulatory Compliance
- Negotiation
- Settlement Handling
- Teamwork and collaboration
- Performance Metrics
- Training and Development
- Customer Service
- Documentation Management
- Client advocacy
- Docs Net Trained
Timeline
Long Term Disability Case Manager
Lincoln Financial Group
01.2015 - Current
Short Term Disability/FMLA Specialist
Liberty Mutual Insurance
01.2010 - 01.2015
Bachelor of Science in Business Administration - Marketing
Vermont State University