About this role
Short-Term Disability Case Manager - Claims Exp is Required - Remote
Job Description: ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps.
This is a remote role, but the following locations are excluded: OCONUS, California, District of Columbia, Illinois, Iowa, Missouri, Montana, New Hampshire, and Rhode Island
Required: - 1-2 years of job-related, full-cycle, Short-Term Disability claims experience - Experience working with integrated claims (short-term, FMLA, etc.) - Demonstrated math proficiency in calculating and processing various employee compensation components (hourly wages, salaries, bonuses, time off). - Good understanding of medical terminology/pathology/anatomy
In this position, you will be responsible for ensuring timely, accurate, and customer-focused decisions and appeals for Short-Term Disability and/or Absence Management claims. A successful candidate will combine strong analytical skills and be able to handle a high caseload.
Day in the Life
Claim Adjudication and Decision-Making:
Render timely and accurate decisions on new and ongoing STD and AM claims.
Proactively gather and analyze relevant clinical, vocational, employer, financial, medical, and other necessary information.
Compare collected data against contract terms, limitations, conditions, and procedural documents to render claims decisions efficiently.
Maintain the confidence to make claim decisions independently.
Case Management and Compliance:
Document the claims system comprehensively and accurately.
Develop, update, and utilize a claims management plan to achieve the most appropriate outcomes.
Ensure full compliance with regulatory requirements and operational standards.
Meet or exceed all established claims team operational metrics.
Customer and Partner Engagement:
Maintain a superior level of genuine caring and empathetic customer service in all interactions.
Act appropriately to earn the trust and confidence of claimants and employers, anticipating their needs.
Collaborate effectively with internal partners, maintaining professionalism, integrity, and fostering high morale.
#LI-Remote
Additional Qualifications/Responsibilities: Must-Haves
High School Diploma (Bachelor's Degree preferred)
1-2 years of job-related, full-cycle, Short-Term Disability claims experience
Experience working with integrated claims (short-term, FMLA, etc.)
Preferred demonstrated proficiency in product-specific areas of STD, LTD, or AM as well as federal and state regulations governing these products and services
Demonstrated math proficiency in calculating and processing various employee compensation components (hourly wages, salaries, bonuses, time off).
Good understanding of medical terminology/pathology/anatomy
Articulate verbal and written communication skills, decision-making, meeting deadlines, and working with confidential information
Moderate skills with Microsoft Office and other software applications
Customer service skills
Ability to manage stress, multitask, prioritize, and work effectively under pressure.
High level of attention to detail
Confidence to make claim decisions
Results-driven orientation
High attention to departmental/company procedures/practices
Position Info:
Pay: $25/hour
Schedule
Training: Monday - Friday | 8am - 5pm EST (approx. 8 weeks in length)
Post-Training: Monday - Friday | 8am - 5pm EST
Career Progression
This is a permanent position with Instant Teams and may result in a full-time, permanent position with the client based on performance and business needs. Additional details to be discussed during the interview process.
This position is 100% remote and provides equipment.
Compliance & Eligibility
Background & Screenings: Successful candidates must complete and pass a background check prior to their start date
Verification: In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.
Work Environment: Because this is a remote work role, you must have:
A quiet, distraction-free work environment
Reliable, high-speed internet
A dedicated and private workspace
Location: Due to specific position requirements, we cannot hire from the following locations for this opportunity: OCONUS, California, District of Columbia, Illinois, Iowa, Missouri, Montana, New Hampshire, and Rhode Island