Remote – open to anyone in U.S. as long as they can work EST hours.
Daily Work Hours: Monday – Friday 8:30am – 5pm EST
Reason the Role Is Open: peak incoming volume
8 Positions open
6 month contract - extension or conversion possible
Case Specialist I, Short Term Disability
You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.
Job Description:
Come join a fantastic team in a fast paced and exciting work environment! Short Term Disability Case Specialists I are responsible for managing routine claims where duration guidelines and/or Clinical resources will assist in determining benefit periods.
What you will do:
Work autonomously and in a team environment to ensure superior service to clients and claimants. Review claims and make final determinations of benefit approval or denial. Approve payment of claims within established limits utilizing Advance Pay and Close guidelines, when appropriate.
• Review duration guidelines and/or recommendations made by Clinical and/or Vocational resources to determine the proper disposition of claims.
• Document and act on Strategy Assessments to ensure that determinations are adjudicated in a timely, accurate, and efficient manner.
• Interpret contracts and ensures consistent, fair claims practices and adherence to appropriate laws, regulations, and procedures.
• Obtain backup documentation, as necessary, to substantiate a disability or communicate via telephone with employers, claimants, physicians, attorneys, and other resources.
• You may handle other related duties such as providing support to other Claims staff or assist in special projects or assignments as a result of business needs.
What you will need to succeed:
• Strong mathematical skills for calculations and claim payments.
• Judgment and decision making skills to adjudicate claims in accordance with policy provisions.
• A proven ability to comprehend and interpret legal and medical terminology in order to make final decisions to approve or further review claims.
• Excellent organization skills and an effective ability to multi-task.
• Effective communication with internal and external contacts and exposure to highly confidential information.
• Client service focus with a solution orientation.
• Effective analytical and problem solving skills.
• Ability to successfully cope in a fast-paced and demanding environment.
• Skilled at working autonomously regarding individual accountabilities and effectively in a team environment.
• Excellent written and verbal communication skills.
• Strong interpersonal skills.
• Demonstrated ability to work to deadlines with a high level of accuracy and attention to detail.
· Regular, reliable and predictable attendance on a full-time basis is also an essential function of this job. This position can be performed working remotely.
Required Education and Skills:
1. Associate or Bachelor degree would be an advantage.
2. 1+ years of customer service or financial services experience.
3. End user computing skills, including proven proficiency in MS Office Outlook, Word and Excel.
4. Able to learn various computer applications.
Nice to have Skills:
1. Associate or Bachelor degree
2. Claim management experience
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