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Disability Case Manager

Job Category:

BPO / KPO / Shared Services

Job Level:


Open Date:




Close date:


Client Industry:


Job Description and Qualification:

? Responsible for managing Long Duration claims to resolution in a proactive manner. This includes determining if insured employees continue to be eligible for disability benefits through to implementing the right interventions to support recovery and return to work.
? Assess claims for continued benefit entitlement by reviewing contractual, medical, functional and occupational information - Sources include, but are not limited to, Independent Medical Evaluations, Functional Capacity Evaluations, medical consultant opinions, Rehabilitation Consultant resources, and consulting Mental Health Experts.
? Assess claims for return-to-work potential and apply strategies based on a variety of interventions including but not limited to: rehabilitation, vocational programs and non-litigated settlements.
? Identify and assess medical and non-medical influencing factors.
? Work collaboratively with insured employees, clients, lawyers, health care practitioners and
other stakeholders to obtain information, provide claim status, create action plans and provide
verbal and written decisions while maintaining confidentiality and privacy.
? Prepare call strategies in advance, including possible interventions and/or claim resolution
strategies. Conduct motivational interviewing within the context of leading exploratory
conversations with plan members who have been on claim for prolonged periods of time.
? Build strong relationships with our clients; employers and their employees.
? Build relationships with third party providers to develop and implement creative solutions to
help plan members develop new skillsets and re-train for new occupations, return to work part-
time and/or at commensurate level.
? Conduct research and keep abreast of new practices and developments in treatment options in
 the medical field.