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Senior Disability Representative

  • Location: Chicago, Cook, Illinois, 60604-2706
  • Salary: 28.57
  • Job Type:Contract

Posted 23 days ago

Long term contract Opportunity!
Title: Senior Disability Representative
Location: Chicago, IL 60604
Term: 6 Months Contract

Day-to-Day Responsibilities:

  • Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to a disability plan
  • Reviews and analyzes complex medical information (i.e. diagnostic tests, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan
  • Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians)
  • Communicates with the claimants providers to set expectations regarding return to work
  • Determines benefits due, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets
  • Medically manages disability claims ensuring compliance with duration control guidelines and plan provisions
  • Communicates clearly with claimant and client on all aspects of claims process either by phone and/or written correspondence
  • Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system
  • Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims
  • Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities
  • Negotiates return to work with or without job accommodations via the claimants physician and employer
  • Refers cases as appropriate to team lead and clinical case management
  • Maintains professional client relationships

Is this a good fit? (Requirements):

  • 3 years of benefits or disability case/claims management experience or equivalent combination of education and experience required
  • Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
  • Working knowledge of medical terminology and duration management
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skills
  • Ability to work in a team environment
  • Excellent negotiation skills
  • Ability to meet or exceed Performance Competencies
  • Bachelor's degree from an accredited university or college preferred

If this sounds like the perfect fit, Apply Today!