Disability Specialist III job at Sedgwick CMS in Atlanta

Sedgwick CMS is presently looking of Disability Specialist III on Sun, 29 Jul 2012 12:43:16 GMT. Baccalaureate degree from an accredited college or university in nursing, social work or vocational rehabilitation is preferred. At least one of the following licenses is required: RN, LVN, CRC, COHN, CVE, LPC or LCSW... Disability Specialist III Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to...

Disability Specialist III

Location: Atlanta Georgia

Description: Sedgwick CMS is presently looking of Disability Specialist III right now, this job will be placed in Georgia. Further informations about this job opportunity please read the description below. Baccalaureate degree from an accredited college or university in nursing, social work or vocational rehabilitation is preferred. At least one of the following licenses is required: RN, LVN, CRC, COHN, CVE, LPC or LCSW.

Disability Specialist III Providing both satisfying and challenging work along with a highly professional and friendly work atmosphere, Sedgwick has a strong commitment to its colleagues and its clients. If you are seeking place where you can do great things for those whose lives you touch while maximizing your own career possibilities, Sedgwick is the place for you. As the largest and most innovative Third Party Administrator in the claims industry and the first and only TPA to receive both recognition as the Best TPA in America and the coveted Employer of Choice designation, we invite you to come be a part of our team and, 'Claim Your Future.' PRIMARY PURPOSE: To analyze reported claims, determine benefits due and make timely payments and adjustments; to medically manage disability claims; to coordinate investigative efforts and to thoroughly review contested claims; to evaluate and arrange appropriate referral of claims to outside vendors; and to negotiate settlement of claims up to the designated authority level. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes, approves and authorizes assigned claims and determines benefits due pursuant to a disability plan.

Determines benefits due, makes timely claims payments and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.

Medically manages disability claims ensuring compliance with duration control guidelines and plan provisions.

Communicates clearly with claimant and client on all aspects of claims process either by phone and/or written correspondence.

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.

Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims.

Evaluates and arranges appropriate referral of claims to outside vendors for surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.

Refers cases as appropriate to supervisor and management.

Negotiates settlement of claims up to designated authority level.

Maintains professional client relationships.

Supports the organization's quality programs(s). QUALIFICATIONS Education & Licensing

Baccalaureate degree from an accredited college or university in nursing, social work or vocational rehabilitation is preferred. At least one of the following licenses is required: RN, LVN, CRC, COHN, CVE, LPC or LCSW. Experience

Three (3) years benefits or disability claims management experience required. Skills & Knowledge Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures

Excellent oral and written communication, including presentation skills

PC literate, including Microsoft Office products

Analytical and interpretive skills

Strong organizational skills

Ability to work in a team environment

Excellent negotiation skills

Ability to meet or exceed Performance Competencies WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, 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 NOTE: Credit security clearance, confirmed via a background credit check, is required for this position. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace

Baccalaureate degree from an accredited college or university in nursing, social work or vocational rehabilitation is preferred. At least one of the following licenses is required: RN, LVN, CRC, COHN, CVE, LPC or LCSW.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Sedgwick CMS.

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This job starts available on: Sun, 29 Jul 2012 12:43:16 GMT

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