Short Term Disability Case Associate

Position : Short Term Disability Case Associate
Location: Remote
Type – Contract

Role Descriptions:

·         To provide disability case management and claim adjudications| based on medical documentation and the applicable adjudications| disability plan interpretation| including determining benefits due and making timely payments and adjustments. –

·         Review and analyze medical information (i.e. diagnostic tests| office notes| operative reports| etc.) to determine if the claimant is disabled as defined by the disability plan.-

·         Able to make required outreaches for missing claims documentations to employee| physicians| or employers.-

·         Utilizes the appropriate clinical resources physicians| in case assessment (i.e. duration guidelines| in-house clinicians).- Partner with clinical and vocational resources to evaluate disability and support return to work goals.- Analyzes|

·         approves and authorizes assigned claims and determines benefits due pursuant to a short term disability plan.-

·         Communicates clearly with the claimants and clients to set expectations on all aspects of claims process either by phone andor written correspondence.-

·         Reviews client critical deliverables| manages the overall workload| and second-level process escalation.-

·         Determines benefits due| makes timely claims payments and or approvals and adjustments for Workers Compensation|

·         State Short Term Disability| and other disability offsets.- Refers cases as appropriate to team lead and clinical case management.-

·         Responsible for managing the day-to-day workload and first-level process escalation| and reviews processes for accuracy and timeliness where applicable in case of peer reviews.-

·         Provide ideas to management on continuous improvement and service level management.-

·         Performs other duties or participates in special projects as assigned.

Essential Skills: Short Term Disability Case Associate Desirable Skills: Keyword: Skills: Insurance - Disability Claims Experience Required: 4-6