Remote Disability Claims Specialist

Alight Solutions Ltd; Washington (District of Columbia); Hybrid; USD 39,000 - 50,000; Full time

Benefits offered by this job

Health benefits

Wellbeing programs

Retirement matching

Generous PTO

Parental leave

Continuing education

Career growth

Job summary

Alight Solutions Ltd is seeking a temporary Disability Case Manager to administer and manage assigned Group Disability claims in line with plan provisions and regulations. You will work with STD, LTD and Risk Management resources to ensure accurate determinations and timely benefits.

The role requires evaluating medical information, coordinating with providers and claimants, and ensuring compliance with federal and state guidelines while supporting return-to-work opportunities and appropriate

Qualifications

• 4-year college education or equivalent work/education experience.
• 2 years disability claim management experience or group insurance experience.
• Ability to clearly communicate claim decisions in writing and verbally.
• Knowledge of candidate regulatory and compliance standards.

Responsibilities

• Outreach to claimants, managers, physicians, HR, payroll and others to gather information.
• Communicate claim status and decisions via phone and written correspondence.
• Obtain information, assess, and issue initial claim decisions with physicians and plan holders.
• Prioritize and review new claims to meet productivity expectations and fast-track claims.
• Investigate and analyze claims to determine coverage and eligibility; draft adverse determinations as needed.
• Determine disability by comparing functional status to job requirements; set up initial benefit approval with medical records.
• Follow claim management procedures and identify return-to-work or accommodation opportunities.
• Utilize MDA and other guidelines, aiming to return claimants to active work.
• Assess offsets when other income is received and recalculate benefits as needed.

Skills

Problem solving

Communication

Numerical aptitude

Multitasking

Analytical skills

Education

Bachelor's degree or equivalent

Job description

Alight Solutions Ltd is seeking a temporary Disability Case Manager to administer and manage assigned Group Disability claims in line with plan provisions and regulations. You will work with STD, LTD and Risk Management resources to ensure accurate determinations and timely benefits.

The role requires evaluating medical information, coordinating with providers and claimants, and ensuring compliance with federal and state guidelines while supporting return-to-work opportunities and appropriate