Excellence In Everything We TouchPosition SummaryUnder general supervision, the Associate Disability Benefits Specialist reviews, evaluates and processes disability insurance claims according to procedure and practice; handling assigned cases from claims receipt to benefit decision. Responsibilities
As directed, receives claim assignment, confirms eligibility and directs acknowledgement of claims
As directed, approves and determines benefits due to a disability plan
Informs claimants of documentation required to process claim and time frames
Interprets and makes decisions as directed on claims and eligibility requirements and determines if claimant meets the eligibility requirements
After initial review of a claim, makes a decision if the claim needs additional medical, employment or educational documentation to confirm the presence or extent of a disability.
Determines if claimants meet the eligibility requirements after investigating and evaluating the information provided
Coordinates referral of claims to outside vendors
Drafts detailed, personalized correspondence to inform claimants of their benefits or ineligibility based on the information provided from claim receipt
Proactively identifies potential fraudulent activities or trends either at the claim level or enterprise level and takes necessary steps as directed to further investigation to ensure any claim approved is eligible on all levels
Under supervision, medically manages claims ensuring compliance with guidelines, procedures and plan provisions.
Upholds the Crawford Code of Conduct
Requirements
Bachelor’s degree or equivalent experience requires
Aptitude for leaning medical terminology and conditions, as well as interpreting procedures and regulations
Ability to work independently while assimilating various technical subjects
Computer knowledge in excel, word, web based systems, etc
Above average verbal and written communication skills
Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures
Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action
Strong ability to identify, analyze and solve problems
Effective interpersonal skills capable of dealing with external sources and all levels of employees
Preferred:
Experience working for a TPA or insurance carrier is desired
Experience in a health or insurance or customer service related industry is desired
About UsWhy Crawford? Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com. When you accept a job with Crawford, you become a part of the One Crawford family.
Our total compensation plans provide each of our employees with far more than just a great salary
Pay and incentive plans that recognize performance excellence
Benefit programs that empower financial, physical, and mental wellness
Training programs that promote continuous learning and career progression while enhancing job performance
Sustainability programs (https://www.crawco.com/about/social-responsibility) that give back to the communities in which we live and work
A culture of respect, collaboration, entrepreneurial spirit and inclusion
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.
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Posted Date8 hours ago(11/11/2024 11:49 AM)Requisition ID2024-26537Job LocationsUS-FL-SunrisePosition TypeRegular Full-TimeCategoryClaimsBusiness UnitBUSTPA US
