Disability Case Manager

Alight; Jersey City (NJ); On-site; USD 35,000 - 65,000; Full time

Job summary

A leading company is seeking a Disability Case Manager responsible for managing Short Term Disability claims, ensuring compliance with state and federal guidelines. The ideal candidate will possess strong problem-solving and communication skills, a relevant educational background, and experience in disability claims management. This full-time position offers flexible working arrangements and comprehensive benefits.

Benefits

Health coverage options

Wellbeing and support programs

Retirement

Vacation and sick leave

Maternity, paternity & adoption leave

Continuing education and training

Voluntary benefit options

Qualifications

• 2 years of disability claim management experience or other Group insurance experience.
• Experience with candidate regulatory and compliance standards.

Responsibilities

• Administer and case manage assigned Group Short Term Disability claims.
• Investigate and analyze claim information to determine coverage and benefit eligibility.
• Communicate claim status and decisions via telephone and in writing.

Skills

Problem Solving

Communication

Math Aptitude

Multitasking

Analytical Skills

Education

4-year college education or equivalent work/education experience

Job description

6 days ago Be among the first 25 applicants

The Disability Case Manager is responsible for administering and case managing assigned Group Short Term Disability claims. They will follow the plan provisions, state and federal guidelines, and established protocols. The CCM works jointly with other team members within STD, and LTD and Risk Management resources. Responsibilities include using efficient and effective means of proactive outreach to obtain and/or dispense information involving claimants, departmental managers, physicians, HR, Payroll, or other sources; communicating claim status and decisions via telephone and in writing; initiating communications to claimant, physician, and/or plan holder to obtain information, make assessment, and initial claim decision; prioritizing and reviewing new claims to adhere to established departmental productivity and meeting productivity requirements for handling “fast track” disability claims with limited durations; investigating and analyzing claim information to determine coverage and benefit eligibility; performing pre-existing condition investigation and drafting adverse determination letters if applicable; determining disability by comparing functionality with job; setting up claim for initial benefit approval including physician statements and medical records; following claim management procedures and identifying potential return to work and job accommodation opportunities; utilizing claim management resources such as Medical Disability Advisor and other disability guidelines; working with the goal of returning claimant to active work status; assessing claims when other sources of income are received to ensure accurate offsets are applied; recalculating benefits as needed and determining under/overpayments. Requirements include independent problem solving and decision-making ability, clear communication of claim decisions and contract language verbally and in writing, math aptitude, multitasking and analytical skills, 4-year college education or equivalent work/education experience, 2 years of disability claim management experience (STD) or other Group insurance experience, and experience with candidate regulatory and compliance standards. Alight requires all virtual interviews to be conducted on video. Flexible working arrangements are considered wherever possible. Benefits include health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training, and several voluntary benefit options. Employment is contingent on successful completion of background checks. Authorization to work in the employing country without visa sponsorship is required.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  International Affairs

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