Group Advantages is looking for Short Term Disability Claims Case Supervisor I. Underneath basic supervision, you’ll develop the information and expertise wanted to conduct thorough investigations, make determinations relating to brief-time period incapacity eligibility for our clients’ staff, present ongoing declare administration, and talk selections and standing updates. Relying on task, you’ll handle complicated brief-time period incapacity claims and can apply applicable contractual provisions, ideas, precept, and protocols to danger handle claims. You may be anticipated to recurrently train unbiased judgment in deciphering info. Since this can be a quick-paced job the place consideration to element counts, and your selections have a direct impression on peoples’ skilled and private lives, it’s essential to show the power to make and successfully talk selections inside tight timeframes whereas integrating information of medical circumstances, buyer contracts and their service degree agreements. Duties:
Communicates with claimants, employers, and numerous medical professionals to collect info relating to the appliance for, cost of, and ongoing management of STD advantages.
Conducts investigations to find out whether or not or to not settle for legal responsibility and to what diploma. Approves or denies advantages accordingly.
Responds to varied written and phone inquiries together with eligibility, approval/denial determinations, standing and continuation or closure of advantages.
Calculates the legal responsibility for every declare making use of all applicable offsets corresponding to social safety, staff compensation and third events.
Regularly assesses declare particulars to find out if claims are going to exceed case management authority tips.
Evaluates and refers applicable claims to danger management assets resembling Vocational Rehabilitation, Managed Care, Fraud, Social Safety, and Subrogation.
Identifies, calculates, communicates, and follows-up on overpayments.
Manages claims inside a number of funding preparations
Updates and precisely paperwork system and declare information on actions taken. Establishes future motion plan and case course
Maintains the established customer support, manufacturing, and high quality requirements
Could also be assigned to offer steerage and help to others.
Qualifications:
Means to collect/analyze info from a number of sources to make selections.
Wonderful telephonic communication and customer support expertise to elicit info and convey selections to quite a lot of audiences clearly, succinctly and diplomatically.
Wonderful organizational expertise to handle a number of priorities and duties for giant caseloads.
Robust written communication expertise to precisely and clearly seize claims standing, actions taken and selections made.
Potential to work independently and as a member of a workforce to realize particular person and workforce goals.
Information of and expertise with knowledge entry and Microsoft Workplace Suite purposes (Phrase, Excel, Outlook) required.
Bachelor’s Diploma most popular, or related, progressively accountable sensible expertise required, to incorporate a minimum of two years in a customer support surroundings.
Information of authorized legal responsibility, insurance protection or medical terminology most popular.
Job: Main Location: United States- New Hampshire-Dover
Schedule: Full-time
Wage: $46,300-$56,600
Journey:
No
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