Job Description : Pay Rate $20 / hr

Training will be in-office - Oriskany, NY

Training duration is 2-4 weeks.

Training hours - 7 : 00 am to 3 : 30 pm EST.

Flex schedule after training - They can log on between 7 : 00-9 : 00am M-F. Logoff time is determined by what time they log on.

If worker loses power or internet for more than 2 hours will need to go to the office to prevent disruptions in service.

Required Skills :

• 2-3 Years in short-term disability claims experience
• Computer literacy - Microsoft Word and Excel in particular
• Strong communication skills, both written and oral.

Key Responsibilities :

o Manages overall block of assigned claims in accordance to Operational Efficiency goals, Demonstrate Service Delivery and Customer Satisfaction goals, including prioritizing actions, appropriately utilizing resources timely, maintain data integrity through accurate benefit decision and payment

o Executes individual claim action plans, serves as point of contact for the claimant and provides a high-level of service to the claimant, including delivering on commitments, timely return of phone calls, and clear communication, and makes claim decisions.

Proactively updates partners that may be working with the claimant when key events are being considered or have occurred. (Closure, RTW, etc.)

o Accountable approves key decisions made by team member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount / Salary and appropriately investigates other income / offsets in accordance with Customer's plan / policy

o Actively demonstrate key behaviors - Active and engaged participant in regularly scheduled 1 : 1s and daily team huddles, Promotes and participate in a work environment including successfully working with others to achieve desired results;

contributes to team goals, projects; exchanges ideas, opinions, develops positive working relationships.

o Performs other related duties as assigned or required

Essential Business Experience and Technical Skills :

Required :

A comprehensive understanding of the disability contractual provisions, especially the definition of disability.

Strong communication skills, including the ability to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim.

Basic knowledge of medical conditions, treatments, prognosis

Critical-thinking skills

Ability to give and receive feedback to / from partners

Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy

Prioritization skills. Ability to balance quantity and quality.

High School Diploma

Preferred : Associate Degree

Associate Degree

2 plus years of claims management experience preferably in Healthcare field

Proficient in Microsoft Word / Excel

Key Competencies, Qualifications and Skills, Preferred :

Some college or degree preferred.

Prior STD and / or Family Medical Leave Act claims knowledge preferred.

Strong communication skills, both written and oral.

Demonstrated critical thinking in activities requiring analysis, investigation, and / or planning.

Strong problem solving and analytical skills.

Ability to work independently.

Ability to multitask, comfortable working with multiple priorities in a changing environment.

Ability to prioritize and maintain quality

Last updated : 2024-05-20