Josefina

Senior Disability Claims Specialist

Evaluate, monitor and manage short term disability (STD), and long-term disability (LTD) claims, Receive, review, follow up, and communicate a determinate whether medical documentation is satisfactory to make a decision on the claim, Manage non-compensable and compensable illness and injuries with requested appropriate medical inquiries and interventions, Lead and monitor the development of best practices in disability management, Manages all facets of claim evaluation for assigned claims, particularly with respect to cause and effect and relating the injury, accident or illness, Collaborate with medical specialists and legal counsel within the organization in order to make a decision on a claim, Present round table reviews for more Complex claims, Monitors the recovery progress of claimants with the purpose of ensuring the employee receives appropriate medical care and is working towards an early and successful return to work, Communicate with claimants, medical professionals, employers, and other relevant parties to obtain necessary information and documentation., Review medical records and other evidence to determine the extent of disability and eligibility for benefits., Collaborate with internal teams, including legal, medical, and compliance, to ensure accurate and timely claim adjudication.

Claims Supervisor

Dispute Resolution Specialist

Customer service Rep