Claims Administrator

Position: Senior Disability Claims AdministratorStart Date: ASAPLocation: Maplewood, NJ - HybridDuration: 10/28/2024 - 04/28/2025Hours: 8:30am - 5:00pmPRINCIPAL ACCOUNTABILITIES:Reviews applications for temporary disability benefits (TBD) claims to ensure that required information is submitted and the appropriate medical documentation is received. Advises employee of what is expected to start/continue TDB benefits.Reviews medical documentation for accuracy, compliance and duration of absence based on medical diagnosis for TDB claims. Communicates verbally and in writing with physician's office regarding questions, concerns in relation to the medical diagnosis, and duration of absence for TDB claims. Sets, maintains and updates TDB claim reserves.Attempts to resolve contractual disagreements prior to a grievance being filed regarding TDB benefit determination in conjunction with contracts, policies and past practices.Workers' Compensation Accountability.Other duties will be discussed.KNOWLEDGE & SKILLS REQUIRED:Four (4) years' experience in disability claims, medical environment or other claims experience. Must be able to apply state disability law to day-to-day situations and communicate the company position on each claim. Familiarity with automated claims management system, investigative skills, and knowledge of medical terminology desirable.

Created: 2024-11-07