Disability Benefit Specialist

Responsibilities

• Manages assigned caseload of disability claims for Short Term/Long Term Disability.
• Communicates with claimants, employers, and various medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of STD or LTD benefits.
• Applies the appropriate contractual provisions; case management resources; and claim processes to ensure eligibility requirements and liability decisions are accurate.
• Provides superior customer service by rendering benefit determinations within expected timeframes and quickly responding to all inquiries.
• Demonstrates ability to independently manage disability claim and apply clinical guidance as provided on more complex claims.
• Verifies on-going disability and participates in claim reviews with specialized resources including nurses, physicians, vocational rehabilitation, etc. to discuss return to work opportunities as appropriate.
• Uses disability claim system to manage and authorize payment on claims while meeting all service, timeframe, and production standards.
• Ensures a timely and appropriately coordinated transition of claims from STD to LTD, providing a well-managed and seamless claims experience to claimants.
• Analyzes claims activity and prepares reports for clients/carriers and management as needed.
• Becomes familiar with specialized client instructions and performance guarantee standards for any assigned clients. Serves as a resource for trainees and Claims processors as needed.
• Effectively works together in a team setting.

Qualifications

• Bachelor's degree or equivalent experience required.
• 2+ years of STD/LTD claims adjudication.
• Experienced in the TPA or self-administration services is desired.
• Experience with FMLA/State leave claims is a plus.
• Aptitude for learning medical terminology and conditions, as well as interpreting procedures and regulations.
• Able to work independently while assimilating various technical resources.
• Computer knowledge in excel, word, web-based systems, etc.
• Good verbal and written communication skills.
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures.
• Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
• Strong ability to identify, analyze and solve problems.
• Effective interpersonal skills capable of dealing with external sources and all levels of employees.

About Us

Join us as a Disability Benefit Specialist and play a key role in evaluating claims, determining benefit eligibility, and guiding employees toward successful return-to-work strategies. Use your expertise in disability policies and medical/vocational issues to deliver clear, timely decisions and exceptional support.

Education

When you accept a job with Crawford, you become a part of the One Crawford family. And as part of the One Crawford family, we offer a comprehensive Total Rewards package to our employees to assist with their financial, health/wellness, continuing education/training and other needs:

• Competitive base pay
• Bonus/Incentive Pay and other Performance-Based Rewards, if applicable.
• We offer a well-rounded benefits package that encourages wellness and helps our employees to be an educated healthcare consumer. The core benefits offered include:
• - Medical, Dental and Vision Plans
• - Prescription Drugs
• - HSA, HRA, and FSA Accounts
• - Paid Holidays, Vacation and Sick Leave
• - 401(k) Retirement Plan
• - Tuition Assistance
• - Paid Parental Leave
• - Supplemental Health Benefits
• Other Benefits currently available at no cost include:
• - Enhanced Mental Health Support
• - Virtual Physical Therapy
• - Caregiving Services
• - Life Assistance Program

The above information highlights some of the benefits currently available to eligible full-time employees.

Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V