Disability Representative

PRIMARY PURPOSE

To process claims and determine benefits due pursuant to a disability plan; to make timely payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets; and to ensure the ongoing processing of claims.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

• Makes claim determinations to approve non-complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
• Determines benefits due, makes timely claims payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
• Informs claimants of documentation required to process claims, required time frames, payment information and claims status either by phone, written correspondence and/or claims system.
• Refers cases as appropriate to team lead; maintains professional client relationships.

ADDITIONAL FUNCTIONS AND RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).

Qualifications

• Education & Licensing: High school diploma or GED required. College preferred. Two (2) years of related experience or equivalent combination of education and experience required to include one (1) year general office or customer service experience. One (1) year of benefits or claims management experience preferred.

Skills & Knowledge

• Excellent oral and written communication
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Ability to work in a team environment
• Ability to meet or exceed Performance Competencies

WORK ENVIRONMENT

• Mental: Clear and conceptual thinking ability; excellent judgment and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
• Physical: Computer keyboarding, travel as required
• Auditory/Visual: Hearing, vision and talking