LTD Claims Case Manager , Disability Job

Employer Name: InsurCrossing	SpiderID: 2347068
Location: Dubuque, Iowa	Date Posted: 7/7/2008
Wage:	Category: Insurance
Job Code:

Job Description:

CLAIM YOUR FUTURE AS A GREAT PERFORMER! Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been recently voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice® designation. Come be a part of our team and Claim Your Future. PRIMARY PURPOSE: To analyze claims and determine benefits due ensuring compliance with plan provisions; to determine need for outside vendors, surveillance, and/or independent medical evaluations; to negotiate settlements and to make claim payments and revisions within designated authority level; and to calculate and collect overpayments.ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: Analyzes assigned claims and determines benefits due Informs claimants of documentation required to process their claim and timeframes Manages claims to ensure compliance with plan provisions Provides appropriate documentation to LTD Manager for reporting purposes Determines need for outside vendors, surveillance and/or independent medical evaluations as required and seeks advice from management, as necessary Refers cases to LTD Supervisor, LTD Manager, or Project Manager Negotiates settlement of appropriate claims within designated authority level Makes claim payments and revisions to benefit amounts Communicates status on decisions to client, claimant and supervisor Calculates and collects overpayments Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims service Qualifications Education & Licensing: Baccalaureate degree from an accredited college or university preferred Licenses as required Experience: Two (2) years of medical disability experience required Skills & Knowledge: Excellent oral and written communication skills, including presentation skills PC literate, including Microsoft Office products Good analytical and interpretive skills Strong organizational skills Excellent interpersonal skills Excellent negotiation skills Ability to work in a team environment Sedgwick CMS is an Equal Opportunity Employer and a Drug-Free Workplace

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Job Criteria:
Start Date:
Position Type: Full-Time Permanent
Years of Experience Required:
Education Required:
Overnight Travel:
Vacation Time:

Contact Information:

Contact Name: -	Company Type: Employer
Company: InsurCrossing

City: Pasadena
State: California
Zip:

Web Site: http://www.insurcrossing.com