Role OverviewProvides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation. Collaborates onsite and has a hybrid work arrangement. Must live near one of our centers of excellence in Orlando, FL.
What You Will Do
Makes independent claim determinations, reviews and analyzes complex medical information, oversees additional facets of complex claims, determines benefits due, and communicates with claimants and providers.
Why It Might Be a Fit
Requires knowledge of ERISA regulations, disability duration and medical management practices, and Social Security application procedures. Must have excellent oral and written communication, analytical, and critical thinking skills.
Requirements
- High School diploma or GED
- Three (3) years of benefits or disability case/claims management experience
- Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
- Knowledge of state and federal FMLA regulations
- Working knowledge of medical terminology and duration management
- Excellent oral and written communication, including presentation skills
- Proficient computer skills including working knowledge of Microsoft Office
- Analytical, interpretive, and critical thinking skills
- Ability to manage ambiguity
- Strong organizational and multitasking skills
- Ability to work in a team environment
- Ability to meet or exceed performance competencies as required by program
- Effective decision-making and negotiation skills
- Ability to exercise judgement autonomously within established procedures
Benefits
- Medical
- Dental
- Vision
- 401k and matching
- PTO
- Disability and life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
]]>