Under general supervision, a Short Term Disability Case Manager is hired to conduct investigations, make determinations regarding short-term disability eligibility for the customers’ employees, and provide ongoing claim administration. Depending on the type of assignment, specific duties may vary, however, the following common responsibilities are often found listed on the Short Term Disability Case Manager Resume – communicating with claimants, employers, and various medical professionals to gather information regarding the application for, payment of and ongoing management of STD benefits, conducting investigations to determine if the liability can be accepted, and to what degree; approving/denying benefits; responding to various written and telephone inquiries including eligibility, and closure of benefits, calculating the ability for each claim applying all appropriate offsets, assessing claim details to determine if claims are going to exceed case management authority guidelines; and guiding others as needed,
To work in this capacity, one needs to possess the following skills and abilities – the ability to gather and analyze information from multiple sources, excellent telephonic communication and customer service skills, excellent organizational skills, strong written communication skills, and knowledge and experience with legal liability, insurance coverage, and medical terminologies. In most cases, a degree is often preferred.
Objective : As a Short Term Disability Case Manager, responsible for Comparing the information to the terms, limitations, and conditions of the contract/administrative services agreement and applicable procedural documents and rendering the claim decision as quickly as possible.
Skills : Micosoft Office, Customer Service.
Description :
FL Trusted provider of clinical content, leading-edge software, absence management outsourcing services, and data analytics to employers, insurers, and healthcare organizations.
FL Provide quality and accurate disability case management and customer service to our client's employees.
Successfully managed 150 plus disability claims consistently.
Provided holistic disability and leave case management.
Obtained and reviewed updated medical evidence for claim decisions.
Provided support for all assigned cases by setting time frames to meet quality assurance and client performance guarantees.
Accessed multiple systems to process claims accurately.
Experience
2-5 Years
Level
Executive
Education
Bachelor Of Arts In Psychology
Short Term Disability Case Manager Resume
Objective : Comprehensive experience in Case Management, Medical Claims, and Client Service Support. Strong back ground in Short Term Disability Case Management and providing education and support. Responsible for conducting investigations to determine approval or denial of benefits. Seeking opportunities in Case Management to offer unique expertise in case developments and managing case files.
Skills : Microsoft Excel, Multitasking.
Description :
Communicated with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits.
Conducted investigations to determine whether or not to accept liability and to what degree.
Approved or denied benefits accordingly.
Responded to various written and telephone inquiries including eligibility, approval/denial determinations, status, and continuation or closure of benefits.
Calculated the liability for each claim applying all appropriate offsets such as social security, workers compensation, and third parties.
Continually assessed claim details to determine if claims are going to exceed case management authority guidelines.
Evaluated and referred appropriate claims to risk management resources such as Vocational Rehabilitation, Managed Care, Fraud, Social Security, and Subrogation.
Experience
0-2 Years
Level
Entry Level
Education
Bachelor's
Short Term Disability Case Manager Resume
Headline : Obtain a Short Term Disability Case Manager position in an office environment that can utilize my ability to interact with others in a positive and effective manner, organizational skills, and support training skills.
Skills : Microsoft word, Case Manager.
Description :
Analyzed, approved, and authorized assigned claims and determining benefits due pursuant to a disability plan.
Determined benefits due, makes timely claims payments and adjustments for disability offsets.
Medically managed disability claims ensuring compliance with duration control guidelines and plan provisions.
Communicated clearly with claimant and client on all aspects of claims process either by phone and/or written correspondence.
Informed claimants of documentation required to process claims, required time frames, payment information, and claims status either by phone, written correspondence, and/or claims system.
Headline : To obtain a Short Term Disability Case Manager position that will allow me to utilize my education and interpersonal skills to assist those that are in need of help.
Skills : Customer Relationship Management, Customer Service, Human Resources, Case Management, Community Outreach, Crisis Intervention.
Description :
Managed both new claims and open claims equally and maintains decision times.
Demonstrated focus on team and office goals by developing an understanding of relationships with our business partners and positively interacting with business partners as needed.
Determined customer eligibility by reviewing the contractual language and medical documentation interpreting information and making decisions based on facts presented.
Worked directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis.
Able to handle potentially high levels of call volume from customers and clients.
Exhibited claim management performance according to quality and compliance standards.
Paid all covered claims accurately and timely.
Experience
5-7 Years
Level
Executive
Education
B.S. In Criminal Justice Administration
Short Term Disability Case Manager Resume
Headline : Seeking a Short Term Disability Case Manager position in claims adjusting case management that will utilize my skills and experience, to achieve excellence and customer reassurance.
Skills : Analyzing Skills, Case Management.
Description :
Analyzed and processed complex claims by investigating and gathering information to determine the exposure on the claim.
Calculated and assigned timely and appropriate reserves to claims; adjusted timely as file facts change.
Calculated and paid benefits due; approved and make timely payments and adjustments.
Managed the litigation process; ensured timely and cost-effective claim resolution.
Managed actions of all professionals involved in a claim, including attorneys, nurse case managers, and investigators, in order to achieve a successful resolution of the claim.
Communicated claim activity and processing with the injured worker and insured/agent.
Maintained professional client relationships.
Experience
5-7 Years
Level
Executive
Education
Business & Web Design
Short Term Disability Case Manager Resume
Objective : To obtain a position where my skills can be utilized and enhanced, thus contributing to the success of my employer. Proficiencies: Medent, along with several other billing software, Insurance Internet Websites, Outlook Express, and Microsoft Excel and Word. Handle multiple phone lines and accurate type at 50 words per minute.
Skills : Microsoft Office, Medical Billing And Coding, Typing.
Description :
Verified all information with Employer, Health Care Provider, and Claimant.
Medically managed claims that are approved and extended.
Ensured the claimant and employers are updated and paid correctly.
Responsible for reviewing disability claims submitted electronically, on paper, and by telephone.
Reviewed medical from Health Care Provider to make the decision to approve, extend or close claim while following Plan guidelines.
Managed claims through a well-developed action plan to an appropriate and timely resolution.
Made timely, accurate, and customer-focused STD, SDI, and AM new and ongoing claim decisions.
Experience
2-5 Years
Level
Executive
Education
High School Diploma
Short Term Disability Case Manager Resume
Objective : Short Term Disability Case Manager with expertise in claims and policy management, review plan documents, member eligibility, benefit and time management calculations, customer service, and account management. Strengths include analytical skills, troubleshooting, customer service, and the ability to learn quickly.
Processed and Managed Short Term Disability and Family Medical Leave Act claims for major corporations in a timely and efficient fashion.
Reviewed detailed medical information.
Ensured proper benefits were paid for an appropriate time frame.
Relayed adverse decisions and create appropriate detailed adverse letters.
Updated claims in accordance with company metrics and/or plan metrics.
Made claim decisions based on analysis of medical information provided Troubleshoot and resolve payment issues, manual calculations Make recommendations for possible process improvements Write in-depth adverse letters when required Act as interim Team Leader.
Provided total claim management from intake to closure, obtain and review medical evidence upon receipt, compose and send communication to both the employer and employee and review guidelines for eligibility resulting in accurate eligibility decisions.
Experience
2-5 Years
Level
Executive
Education
Bachelors In Healthcare Administration
Short Term Disability Case Manager Resume
Headline : As a Short Term Disability Case Manager, responsible for Documenting the claim systems in an accurate and comprehensive manner while maintaining maximum levels of efficiency, and also Preparing and disseminating articulate written and verbal communication to assorted internal and external sources.
Skills : Excel, Microsoft Office, Time Management.
Description :
Managed an assigned caseload of disability claims.
Input claimant medical and demographic data.
Evaluated customer eligibility.
Developed plans to address disability obstacles with customers, attending physicians, and employers.
Monitored medical conditions of customers and discuss return to work with employers.
Followed up and monitored payments accuracy and timeliness and follows claim to closure.
Assisted employees and employers with questions regarding disability claims.
Experience
5-7 Years
Level
Executive
Education
Bachelors Of Arts In Sociology
Short Term Disability Case Manager Resume
Objective : Short Term Disability Case Manager with 3+ years of experience in working as a team to support one another through flexibility, collaboration, creating a positive work environment, consistently maintaining professionalism and integrity, actively taking steps to foster high morale, and demonstrating dedication to excellence.
Skills : Networking, Communication Skills.
Description :
Reviewed and take action on STD claims.
Entered CPT and ICD 9 Codes.
Gathered and evaluated medical documentation.
Made case decisions to approve or deny.
Coordinated with Physician Offices, Employees, and/or Employers to gather the required information to process the claim correctly and accurately.
Networked with both the customer and their physician to medically manage the claim from the initial medical requests to the review and evaluation of ongoing medical information.
Worked directly with employers to facilitate a return to work either on a full-time or modified duty basis.
Experience
2-5 Years
Level
Executive
Education
MS
Short Term Disability Case Manager Resume
Headline : Over a year and a half of assisting residents in nursing homes, taking care of their medications, and making sure they are helped in a timely manner, as well as I've two years of experience in customer service. Demonstrates excellent customer service skills in problem-solving in fast-paced environments. Excellent at problem-solving and making sure tasks are completed on time.
Skills : Training Skills, Planning Skills, Evaluation Skills.
Description :
Provided consistent customer service to both our customers and claimants through timely responses to all inquiries, telephone calls, and e-mails while delivering on service commitments.
Paid all covered claims accurately Understand and interpret contractual language and responsibilities Manage both new claims daily as well as open claims equally.
Composed and sent communications to both the client and claimant.
Used problem-solving skills and multiple resources to resolve employee disability issues.
Managed claims within multiple funding arrangements Updated and accurately documents system and claim files on actions taken.
Established future action plans and case directions.
Evaluated and arranged appropriate referral of claims to outside vendors for surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
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