Recertification Claims Specialist

Job Description

REQUIREMENTS

• High School diploma or GED or minimum Associate degree in lieu of required experience.
• 3-5 years of long term disability claims experience directly aligned to the specific responsibilities for this role or; For candidates with an Associate degree, 0-1 year claims experience directly aligned to the specific responsibilities for this role.
• Strong written and verbal communication skills.
• Excellent organization skills with the ability to multi-task.

Nice-to-haves:

• Experience with disability and/or absence management.

RESPONSIBILITES

• Communicating with claimants, employers and various medical professionals through phone and e-mail to gather information regarding Long Term Disability Claims and state and federal benefits when applicable.
• Collaborating with fellow case managers, nurse case managers, vocational case managers, and consulting physicians to make appropriate, ethical, and timely claim determinations.
• Reviewing complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning throughout the life of the claim.
• Providing exceptional customer service and proactively recognizing customer needs and areas of opportunity.

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