BCforward is currently seeking for a highly motivated Disability Specialist at Eden Prairie, MN 55344 Job Title: Disability Specialist Location: Eden Prairie, MN 55344 Duration: 7 months
Job Description
PRIMARY PURPOSE: To analyze reported claims, determine benefits due and make timely payments and adjustments; to medically manage disability claims; to coordinate investigative efforts and to thoroughly review contested claims; to evaluate and arrange appropriate referral of claims to outside vendors; and to negotiate settlement of claims up to the designated authority level. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to a disability plan. Determines benefits due, makes timely claims payments 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 for surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities. Refers cases as appropriate to supervisor and management. Negotiates settlement of claims up to designated authority level. Maintains professional client relationships. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). QUALIFICATIONS Education & Licensing Bachelor's degree from an accredited college or university in nursing, social work or vocational rehabilitation is preferred. At least one of the following licenses is required: RN, LVN, CRC, COHN, CVE, LPC or LCSW. Experience Four (4) years of benefits or disability claims management experience or equivalent combination of education and experience required. Skills & Knowledge Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures 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 WORK ENVIRONMENTWhen applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking NOTE: Credit security clearance, confirmed via a background credit check, is required for this position. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Qualifications:
Is it WFH/ Remote position or onsite? WFH/Remote Any specific skills or requirement you are looking? No specific requirements, but general knowledge/use of a computer and familiarity with using 2 monitors Does provides the equipment to candidates if the position is Remote/WFH? Yes, we would confirm a shipping address for the candidate and FedEx all required equipment Monitors, laptop, headsets, etc.
Education:
High School Graduate/GED
Interested candidates please send resume in Word format Please reference job code 144147 when responding to this ad.
