Communicate with claimants, employers and various medical professionals through phone and e-mail to gather information regarding the Short-Term Disability claim.
Collaborate with fellow case managers, nursing case managers and consulting physicians to make appropriate and timely claim determinations.
Review complex medical records and effectively leveraging a variety of tools and resources to understand appropriate approval durations and future action planning.
Complete accurate financial calculations consistent with company and state guidelines.
Provide exceptional customer service and proactively recognize customer needs and areas of opportunity.
Identify and recommend process improvements and organizational initiatives to positively influence the team and quality.

High School diploma or GED
1-2 years of experience in claims, leaves or customer service
Strong written and verbal communication skills
Excellent organization skills with the ability to multi-task
Ability to work with others in a fast-paced, team environment
Ability to quickly learn complex systems and product knowledge
Ability to navigate through multiple systems/databases/platforms/software while engaging in customer conversations
Ability to be adaptable/flexible as business needs change
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
Must have internet bandwidth of 12 Mbps (Megabits per second). Preferred bandwidth is 25 Mbps to perform at full capacity.

Short Term Disability Claims Specialist

Key skills