Remote Disability Case Manager (Temporary)

Alight Solutions Ltd; Indiana; On-site; USD 39,000 - 50,000; Full time

Job summary

The temporary Disability Case Manager at Alight Solutions in Indiana administers and case-manages assigned Group Disability claims, following plan provisions, state and federal guidelines, and established protocols in collaboration with STD, LTD, and Risk Management teams.

You will communicate claim status, gather information from claimants, physicians and HR, prioritize fast-track claims, assess eligibility, and identify return-to-work opportunities while adhering to regulatory standards and

Qualifications

• Demonstrate independent problem solving and decision-making.
• Clear communication of claim decisions verbally and in writing.
• Demonstrate math aptitude, ability to multitask, and analytical skills.
• Have 4-year college education or equivalent work/education experience.
• Experience of 2 years of disability claim management experience, or other Group insurance experience.
• Experience with candidate regulatory and compliance standards.

Responsibilities

• Using most efficient and effective means of proactive outreach to obtain and/or dispense information to claimants, 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 productivity standards and fast-track requirements.
• Investigating and analyzing claim information to determine coverage and benefit eligibility; 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.
• Following claim management procedures and identifying return-to-work or accommodation opportunities.
• Utilizing MDA and other disability guidelines to return claimants to active work status.
• Assessing offsets and recalculating benefits to address over/underpayments.

Skills

Problem solving

Communication

Math aptitude

Multitasking

Analytical skills

Education

4-year college education

Job description

The temporary Disability Case Manager at Alight Solutions in Indiana administers and case-manages assigned Group Disability claims, following plan provisions, state and federal guidelines, and established protocols in collaboration with STD, LTD, and Risk Management teams.

You will communicate claim status, gather information from claimants, physicians and HR, prioritize fast-track claims, assess eligibility, and identify return-to-work opportunities while adhering to regulatory standards and