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Senior Disability Representative

  • Location: Chicago, 60604
  • Job Type:Contract

Posted about 1 month ago

Position: Senior Disability Representative
Location: Chicago, IL 60604
Term:  6 months
 
Day-to-Day Responsibilities:
  • Provide disability case management and claim determinations based on complex medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims.
  • Coordinating investigative efforts, thoroughly reviewing contested claims, negotiating return to work with or without job accommodations, and evaluating and arranging appropriate referral of claims to outside vendors.
  • 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 claimant’s 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 claimant’s physician and employer.
  • Refers cases as appropriate to team lead and clinical case management.
  • Maintains professional client relationships.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).
 
Is this a good fit? (Requirements):
  • 3 years’ experience of benefits or disability case/claims management experience or equivalent combination of education and experience.
  • Knowledge of ERISA regulations, offsets and deductions, disability duration and medical management practices and Social Security application procedures.
  • Working knowledge of medical terminology and duration management.
  • Excellent oral and written communication, including presentation skills 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.
 
Even better if you have:
  • Bachelor's degree from an accredited university or college.
 

Candidates will be responsible for following the client's COVID-19 protocols. Please refer to your MATRIX representative for specifics.

About Us

At MATRIX, we expertly match talented professionals with job opportunities to elevate careers. Since 1983, we have placed thousands of professionals at innovative clients across every industry ranging from small startups to Fortune 50 companies. It’s why we’re consistently in the top 25 of all U.S. IT staffing firms and why our consultants rate us well above the industry average, earning us ClearlyRated's Best of Staffing awards year after year. People come to us for a job, and stay with us because of our top-notch consultant care.

MATRIX is and Equal Employment Opportunity employer including disability and veteran and provides reasonable accommodations for all qualified individuals.  Supporting medical or religious documentation will be required where applicable. If you are a qualified individual you may request a reasonable accommodation under the American Disability Act (ADA). If you are a person with a disability needing assistance applying, or at any point in the hiring process, please email us at MATRIX_HR@MatrixRes.com. To ensure a quick response to your request, please use the words “Accommodation request” as the subject line of your email.