Senior Disability Representative

Responsibilities

• Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments
• Medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations
• Coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors

• High School diploma or GED required
• Bachelor's degree from an accredited university or college preferred
• State certification or licensing in statutory leaves is preferred or may be required based on state regulations
• Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
• Knowledge of state and federal FMLA regulations
• Working knowledge of medical terminology and duration management
• Excellent oral and written communication, including presentation skills
• Proficient computer skills including working knowledge of Microsoft Office
• Analytical, interpretive, and critical thinking skills
• Ability to manage ambiguity
• Strong organizational and multitasking skills
• Ability to work in a team environment
• Ability to meet or exceed performance competencies as required by program
• Effective decision-making and negotiation skills
• Ability to exercise judgement autonomously within established procedures

Demonstrates expertise in disability case management, including knowledge of ERISA regulations, FMLA regulations, and medical terminology. Proficient in analytical decision-making, negotiation, and effective communication within a team environment.