Claims Examiner (Long Term Disability)
|April 30, 2013 - August 07, 2013|
|Benefits:||Full Benefits, PTO, 401K|
|Employment Type:||Full Time|
|Department:||Long Term Disability|
|Description:||The Claims Examiner (Long Term Disability) will manage an assigned caseload of more complex Integrated Long-Term Disability cases. Candidate will also evaluate claimant eligibility. Interact with internal and external customers including, but not limited to, claimants, employers, physicians and attorneys etc. to gather the information to make the decision on the claim.|
|Duties:|| Analyze, approve or deny Disability claims for contestable and non-contestable cases. |
Provides technical direction to other claims personnel as needed.
Determining eligibility under federal and state requirements for leaves submitted.
Medical certification review and management supplied by the healthcare provider.
Determining the duration associated with the leave based on the information given by the healthcare provider.
Communicating approvals, denials, leave extensions, return to work plans and other important information regarding the leave to the employee and client.
Managing leaves that are concurrent with Short Term Disability and Workers Compensation.
Managing intermittent, continuous and client specific leaves of absences.
Processing all leaves within the specific timeframes outlined within Matrix Best Practices guidelines.
Validates payment period, follows up and monitors payment accuracy and timeliness; follows plan to closure.
Other duties as assigned
|Qualifications:|| College Bachelors degree preferred.|
At least 1-2 years of experience directly administering LTD or STD Claims.
Additional experience administering FMLA and/or State Leaves is a (+).
Ability to manage multiple and changing priorities.
Excellent organizational and time management skills.
Strong written and communication skills demonstrated in previous work experience.
Specific experience with collaborative negotiations.
Proven skills in positive and effective interaction with challenging customers.
Experience in effectively meeting/exceeding individual professional expectations and team goals.
Demonstrated analytical and math skills.
Ability to exercise sound judgment.
High level of flexibility to adapt to the needs of the organizations.
PC skills preferred (i.e. Windows based environment).
Knowledge of medical terminology desired.
Matrix Absence Management is a nationwide company that partners with employers to provide customized management of disability, workers compensation and family leave programs.
We service a wide range of nationwide clients. Our clients include Fortune 500 companies, Technology sector leaders, Service Companies, Manufactures, Bio Tech, Utilities and Healthcare.
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