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Disability Specialist- Remote, US

  • Job ID: 092700776
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Disability Specialists
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $25.81 to $44.67 / hour

Description

UPMC Workpartners has an exciting opportunity to add a Disability Specialist to their tight-knit, collaborative team!

 
The Disability Specialist will provide accurate claims adjudication and superior customer service to all of UPMC and WorkPartners customers.

This team offers a fast-paced environment that handles a caseload of Short-Term Disability cases. Teams are based on collaboration with one another.  

This is a full time, daylight, work-from-home position. Apply today!


Responsibilities:

  • Independently manages STD caseload within current process and procedures. Utilizes Clinical nurse Case Manager and/or Medical Director resources within established guidelines
  • Analyzes claims and determines benefits due on claims in accordance to the ERISA regulations and policy provisions.
  • Provide thorough claim management that includes timely notification and follow-up, thorough employee understanding, accurate documentation and appropriate referrals.
  • Participate in training activities to keep skill set updated.
  • Authorizes timely claim payments upon receipt of appropriate medical information.
  • Calculates and assigns accurate benefit calculations to each claim and monitors benefit payments.
  • Investigates claims and determines eligibility for Short-Term Disability benefits.
  • Utilizes Clinical nurse Case Manager and/or Medical Director resources within established guidelines.
  • Interact with physicians, medical providers, claimants and employers either in writing or by telephone.
  • Support partnership with vocational team to ensure proactive claims management plans are set and established return to work and Stay at Work (SAW) processes are followed
  • Maintains excellent communications with employees, employers, human resources and disability team.

 

Qualifications

  • High school graduate required
  • College degree and/or professional certifications preferred
  • A minimum of 3 years of disability claims management experience
  • Skills include: Excellent organizational and time management skills.
  • Excellent written and verbal communication skills including the ability to communicate clearly by telephone and/or in writing.
  • Working knowledge of Microsoft office products including Microsoft Outlook.
  • Strong knowledge of Short-Term Disability to ensure solid and consistent claims determinations.
  • Strong medical knowledge


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct