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 : Dedicated Short Term Disability Case Manager with 2 years of experience in managing disability claims and providing exceptional client support. Skilled in analyzing medical documentation and ensuring compliance with policy guidelines. Committed to facilitating effective communication between clients, employers, and healthcare providers to streamline the claims process and enhance client satisfaction.
Skills : Regulatory Compliance, Data Analysis, Disability Assessment, Claims Processing
Description :
Provided comprehensive case management for over 150 disability claims, ensuring timely and accurate processing.
Delivered exceptional customer service by addressing employee inquiries regarding their disability claims.
Conducted thorough evaluations of medical evidence to determine eligibility for claims.
Collaborated with healthcare providers to obtain necessary documentation for claims processing.
Developed and maintained detailed case notes to track claim progress and outcomes.
Ensured compliance with company policies and legal regulations throughout the claims process.
Utilized multiple systems to accurately process claims and maintain client records.
Experience
0-2 Years
Level
Entry Level
Education
BSHA
Short Term Disability Coordinator Resume
Objective : Proficient Short Term Disability Coordinator with over 5 years of experience in managing disability claims and enhancing client communication. Expertise in analyzing medical documentation to ensure compliance with regulations and optimize benefit approvals. Passionate about providing exceptional support and facilitating swift resolutions for clients, employers, and healthcare providers.
Skills : Data Analysis And Reporting, Critical Thinking, Attention To Detail, Crisis Management, Team Collaboration
Description :
Collaborated with claimants, employers, and healthcare professionals to gather necessary information for short-term disability claims.
Conducted thorough investigations to assess liability and determine claim eligibility.
Approved or denied benefits based on comprehensive analysis of medical documentation.
Addressed inquiries regarding claim status, eligibility, and benefit determinations through effective communication.
Calculated liabilities for claims while applying relevant offsets such as social security and workers compensation.
Monitored claims to ensure compliance with management authority guidelines and regulations.
Referred complex cases to risk management resources to ensure comprehensive support for claimants.
Experience
2-5 Years
Level
Junior
Education
B.S. Health Admin.
Short Term Disability Case Manager Resume
Headline : Accomplished Short Term Disability Case Manager with over 7 years of experience in effectively managing disability claims and ensuring compliance with regulatory standards. Adept at analyzing complex medical documentation and facilitating clear communication among clients, healthcare providers, and employers, resulting in improved claim processing and client satisfaction.
Reviewed and authorized disability claims, determining benefits due according to policy guidelines.
Ensured timely claims payments and adjustments in compliance with disability offsets.
Managed medical documentation to adhere to duration control guidelines and plan provisions.
Facilitated clear communication with claimants on all claims process aspects via phone and written correspondence.
Informed claimants about necessary documentation, timelines, and claims status through various communication methods.
Coordinated investigative efforts to ensure claims appropriateness and compliance.
Conducted thorough reviews of contested claims to determine resolution pathways.
Experience
5-7 Years
Level
Senior
Education
B.S. Health Admin
Short Term Disability Claims Specialist Resume
Summary : With a decade of expertise in Short Term Disability claims management, I excel in evaluating complex medical documentation and ensuring compliance with industry regulations. My strong analytical skills and commitment to client communication facilitate timely claim resolutions, enhancing overall stakeholder satisfaction and operational efficiency.
Managed new and ongoing short-term disability claims, ensuring adherence to regulatory requirements.
Analyzed complex medical documentation to determine eligibility and compliance with policy guidelines.
Collaborated with various stakeholders, including healthcare providers and employers, to facilitate effective communication.
Monitored claim processing metrics and performance standards to meet organizational goals.
Provided high-quality customer service, addressing inquiries and resolving issues promptly.
Trained new staff on claims management processes and compliance standards.
Maintained accurate records and documentation for all claims activity.
Experience
7-10 Years
Level
Management
Education
B.S. Health Admin.
Short Term Disability Case Manager Resume
Summary : Highly experienced Short Term Disability Case Manager with a decade of expertise in managing complex claims and ensuring adherence to regulatory standards. Proficient in analyzing medical documentation, facilitating effective communication among stakeholders, and driving optimal claim resolution strategies to enhance client satisfaction and operational efficiency.
Skills : Medical Documentation Analysis, Client Relations, Training And Development, Multitasking, Emotional Intelligence, Cultural Competence
Description :
Evaluated and processed complex short-term disability claims, ensuring compliance with industry standards.
Calculated and assigned accurate reserves for claims, adjusting as necessary based on evolving case facts.
Facilitated timely benefit payments and adjustments to approved claims.
Coordinated with legal professionals and case managers to drive efficient claim resolutions.
Maintained transparent communication with clients and stakeholders regarding claim statuses and processes.
Developed and upheld professional relationships with clients to foster trust and satisfaction.
Conducted thorough investigations to determine claim validity and exposure.
Experience
10+ Years
Level
Executive
Education
B.S. Health Mgmt.
Short Term Leave Case Manager Resume
Objective : Experienced Short Term Leave Case Manager with 5 years in effectively overseeing disability claims and ensuring compliance with industry standards. Proficient in evaluating medical documentation and fostering communication among clients, employers, and healthcare providers to facilitate timely resolutions and enhance client satisfaction.
Skills : Microsoft Office Suite, Claims Analysis And Management, Case Management, Problem Solving
Description :
Verified all information with employers, healthcare providers, and claimants to ensure accuracy.
Managed claims through comprehensive action plans, achieving timely resolutions.
Reviewed disability claims submitted electronically and via phone, ensuring compliance with plan guidelines.
Analyzed medical documentation to determine claim approvals and extensions, adhering to policy standards.
Communicated effectively with clients and employers regarding claim status and updates.
Processed new and ongoing claims, delivering customer-focused decisions on STD and SDI claims.
Facilitated efficient claims management by coordinating with multidisciplinary teams.
Experience
2-5 Years
Level
Consultant
Education
B.S. Health Admin.
Short Term Disability Case Manager Resume
Objective : Dynamic Short Term Disability Case Manager with 2 years of specialized experience in overseeing disability claims and ensuring adherence to policy standards. Proficient in evaluating medical documentation and facilitating seamless communication among clients and healthcare professionals, driving efficient claim resolutions and enhancing client satisfaction.
Skills : Claims Analysis, Medical Documentation Review, Documentation Skills, Workplace Accommodations, Legal Knowledge, Health Care Systems
Description :
Assess and process short-term disability claims efficiently and accurately.
Reviewed and analyzed detailed medical documentation to determine claim eligibility.
Ensured timely benefit payments by monitoring claims within the appropriate time frame.
Communicated adverse decisions effectively, crafting detailed letters for clients.
Updated claims in line with company metrics and guidelines, ensuring compliance.
Utilized analytical skills to troubleshoot payment issues and recommend process improvements.
Managed claims from intake to closure, providing clear communication to employers and employees.
Experience
0-2 Years
Level
Fresher
Education
B.S. Health Admin.
Short-Term Leave Administrator Resume
Headline : Bringing over 7 years of specialized experience in managing short-term disability claims, I excel in interpreting medical documentation and ensuring strict compliance with regulatory standards. My focus on clear communication with clients, employers, and healthcare providers has consistently led to streamlined processes and enhanced satisfaction.
Managed a diverse caseload of short-term disability claims, ensuring timely and accurate processing.
Input and maintained claimant medical and demographic data in compliance with privacy regulations.
Evaluated customer eligibility and developed individualized plans to address disability challenges.
Monitored medical conditions and facilitated return-to-work discussions with employers.
Ensured payment accuracy and timeliness, bringing claims to resolution.
Provided expert assistance to employees and employers regarding claims inquiries.
Maintained comprehensive documentation for all claims to ensure compliance and audit readiness.
Experience
5-7 Years
Level
Senior
Education
B.S. in BA
Short Term Disability Case Manager Resume
Objective : Results-oriented Short Term Disability Case Manager with 5 years of experience in efficiently managing disability claims and ensuring compliance with organizational standards. Proficient in analyzing medical records and facilitating clear communication among clients, healthcare providers, and employers to expedite claim resolutions and improve client satisfaction.
Skills : Stakeholder Engagement, Policy Interpretation, Health Care Knowledge, Technical Proficiency, Customer Service, Negotiation Skills
Description :
Reviewed and processed Short Term Disability (STD) claims, ensuring accurate documentation and adherence to guidelines.
Analyzed CPT and ICD codes to validate medical claims and facilitate decision-making.
Evaluated medical documentation and coordinated with healthcare providers to support claim assessments.
Made informed case decisions regarding claim approvals or denials based on policy compliance.
Collaborated with clients, employers, and healthcare providers to gather necessary information for claim processing.
Managed ongoing communication with stakeholders to address any claim-related inquiries and concerns.
Facilitated return-to-work strategies for employees, promoting a smooth transition back to their roles.
Experience
2-5 Years
Level
Junior
Education
B.S. Health Admin
Short Term Disability Case Manager Resume
Summary : Bringing a decade of experience in Short Term Disability claims management, I specialize in evaluating medical documentation and ensuring strict adherence to regulatory standards. My expertise in case coordination and stakeholder communication drives timely resolutions, enhancing client satisfaction and operational efficiency.
Skills : Claims Evaluation, Communication Skills, Networking Skills, Time Management, Motivational Skills
Description :
Delivered exemplary service to clients and claimants through prompt responses to inquiries and communication, fulfilling service commitments.
Accurately processed all covered claims while interpreting contractual obligations and managing new and ongoing claims effectively.
Authored clear and concise communications for clients and claimants, ensuring transparency throughout the claims process.
Utilized analytical and problem-solving skills to resolve complex employee disability issues efficiently.
Maintained meticulous documentation of claims and system updates to support audit compliance and reporting.
Developed actionable plans for claims management, enhancing the effectiveness of case resolutions.
Coordinated referrals to external vendors for medical evaluations and surveillance, optimizing claims outcomes.
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