Integrated Claims Examiner- Leave of Absence
Location: Hawthorne, New York
Description: Matrix Absence Management is at present recruited Integrated Claims Examiner- Leave of Absence right now, this job will be reside in New York. For detail informations about this job opportunity kindly read the description below. DESCRIPTION
Selected candidate will manage an assigned caseload of more complex FMLA and Integrated FMLA and Disability cases.
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- Candidate also evaluates claimant eligibility. Interacts with internal and external customers including, but not limited to, claimants, employers, physicians, attorneys etc. to gather the information to make the decision on the claim.
- Analyzes, approves or denies Disability claims for contestable and non-contestable cases.
- Provides technical direction to other claims personnel as needed.
- Validates payment period, follows up and monitors payment accuracy and timeliness; follows plan to closure.
- Candidate will determine eligibility under federal and state requirements for leaves submitted.
- Medical certification review and management supplied by the healthcare provider.
- Determining the duration associated with the leave based on the information given by the healthcare provider.
- Communicating approvals, denials, leave extensions, return to work plans and other important informatio! n regarding the leave to the employee and client.
- Man! aging leaves that are concurrent with Short Term Disability and Workers' Compensation.
- Managing intermittent, continuous and client specific leaves of absences.
- Processing all leaves within the specific timeframes outlined within Matrix Best Practices guidelines.
- 3 or more years of Disability Claims Administration experience.
- Minimum Bachelor's Degree required or 5 years of requisite industry experience.
- Thorough knowledge of ERISA regulations and Self Insured Disability Plans.
- Ability to manage the medical aspects of a claim from onset to return to work, utilizing industry standard tools and strategies.
- Working knowledge of Federal and State Leave Laws.
- Excellent organizational and time management skills.
- Strong written and communication skills demonstrated in previous work experience.
- Specific experience with collaborative negotiations.
- Pro! ven skills in positive and effective interaction with challenging customers.
- Experience in effectively meeting/exceeding individual professional expectations and team goals.
- Demonstrated analytical and math skills.
- Ability to exercise sound judgment.
- High level of flexibility to adapt to the needs of the organizations.
- PC skills preferred (i.e. Windows based environment).
We service a wide range of nationwide clients. Our clients include Fortune 500 companies, Technology sector leaders, Service Companies, Manufactures, Bio Tech, Utilities and Healthcare. *Candidate will determine eligibility under federal and state requirements for leaves submitted.
- Medical certification review and management supplied by the healthcare provi! der.
- Determining the duration associated with the leave based ! on the information given by the healthcare provider.
- Communicating approvals, denials, leave extensions, return to work plans and other important information regarding the leave to the employee and client.
- Managing leaves that are concurrent with Short Term Disability and Workers' Compensation.
- Managing intermittent, continuous and client specific leaves of absences.
- Processing all leaves within the specific timeframes outlined within Matrix Best Practices guidelines.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Matrix Absence Management.
Interested on this job, just click on the Apply button, you will be redirected to the official website
This job will be opened on: Wed, 22 May 2013 17:38:19 GMT
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