As a Disability Claims Nurse, you will perform the low complexity nurse review for STD and LTD claims. You will need the knowledge and skills to conduct thorough investigations of disability claims. This is a fast-paced job where attention to detail counts. The Disability Claims Nurse will have direct impact on claimant health, well-being and sense of security. This person must have the ability to make effective decision and communicate decisions within tight time frames, while integrating knowledge of medical conditions, customer contracts, and corporate compliance are critical for success.Responsibilities
As a Disability Claims Nurse, You Are Responsible for:
• Provide Clinical guidance, support and recommendation on a claim whenever requested by a case manager through phone call or request for clinical consultation or referral submitted through email
• Having direct communication with various medical professionals to gather information regarding the claim for, short-term, long-term and rehabilitation disability benefits.
• Handle potentially high levels of inbound correspondence from claimants and medical professionals. There correspondences maybe via written, faxed and/or emails response of the request for medical records. Also guide the disability claims associate as they perform task.
• Work directly with clients to facilitate return to work assessments.
• Delivery of clients expectations outlined in the scope of work (SOW).
• Adherence to standard timeframes for processing mail, tasks and outliers as outlined in the scope of work. Also guide the disability claims associate performing task.
• Understand Operations and Corporate Compliance, Policies and Procedures and Best Practices.
• Stay abreast of ongoing trainings associated with role and business unit objectives.
• Respond to all telephonic and email inquiries within client service protocols (SOW) in a clear, concise and timely manner. Also guide the disability claims associates performing task.
Long Term Disability, Short Term Disability, Low Complexity Nurse Review and Vocational Rehabilitation Service. required
Strong interpersonal and demonstrated teamwork and collaboration. required
Demonstrated analytical and clinical critical thinking skills. required
In-depth knowledge and understanding of the Independent Medical Examination process. required
In-depth knowledge and understanding of the High Level Review process. required
Proven ability to organize and prioritize; demonstrated success in multitasking and managing multiple, competing priorities.
Strong ability to communicate at all levels with clarity and precision, both written and verbal.
Ability to adapt in a changing work environment.
Advanced technical/computer skills, including MS Word, Excel, PowerPoint, Share Point, etc.
Associate Degree in Nursing required.
Registered Nurse with current, valid unrestricted licensure in the state of Florida. required
Degree from an institution that is fully accredited by a nationally recognized educational accreditation organization. required
Work Experience Requirements:
Work experience in Long Term Disability, Short Term Disability, and Vocational Rehabilitation Service. PreferredEEO Statement EEO/Minorities/Females/Vets/Disabilities Options Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed
Software Powered by iCIMS