Disability Transition Specialist

Job Responsibilities and Requirements

KEY RESPONSIBILITIES

• other duties as assigned*

Provides technical guidance, advice and coaching for Short Term Disability (STD) claims records approaching maximum plan duration. Responsible for, along with the Manager of the STD unit, the quality of work, productivity, appropriate and timely transitions to Long Term Disability (LTD) and service related to those claims.

Duties and Responsibilities:

• Manages the processing of Short Term Disability (STD), Voluntary STD claims approaching maximum plan duration to ensure timely and appropriate adjudication within Company guidelines. Consults with STD Manager on cases as needed.

• Reviews claims to ensure, among other things, that decisions related to eligibility, disability, offsets, benefit calculations and ongoing claim management are accurate and appropriate.

• Uses expertise in claim management practices to provide claim-specific guidance and direction to examiners for claims approaching maximum STD plan duration to ensure timely and appropriate LTD claims.

• Documents findings in master spreadsheet and is able to articulate trends and inconsistencies and provide suggestions to improved behavior and results.

• Ensures achievement of specific customer service, quality and production objectives by following Key Performance Indicators 9KPI's, metrics, client specific special handling and confirming claims examiners file direction.

• Collaborates with management and business partners in the development, organization and execution of improvement opportunities and performance capabilities.

• Ensures process consistency through continuous communication with the examiners.

• Tracks performance issues/trends and identifies opportunities for improvement and training, both individually and collectively for specific examiner reviews and broad trends across the teams and department.

• Assists Management in staff assessment, development, skills training and application of new processes and technology.

• Supports training efforts through coaching involvement and reinforcement/follow-up with examiners.

• Provides regular feedback to the Management regarding performance and developmental opportunities of the relevant claims personnel.

• Regularly meets with Management and staff to discuss new procedures, trends identified in reviews, reinforce training efforts, communicate results, discuss changes, discuss issues, share information or problems, and provide a forum for team building.

• Suggests changes to policy language as necessary and participates in the development of new products.

• Develops, models and maintains effective working relationships with external (policyholders, brokers) and internal (sales, underwriting, administration) contacts.

• Handles a caseload, as necessary.

• Maintains consistent regulatory compliance within staff through appropriate communication and training.

• Completes special projects as assigned by Management.

• Able to make independent decisions on file direction and claim management next steps.

• Testifies in legal hearings as required.

• Travels (overnight) as required.

• All other duties as assigned.

REQUIRED KNOWLEDGE, SKILLS, ABILITIES, COMPETENCIES, AND/OR RELATED EXPERIENCE

• or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*

Required Knowledge, Skills, Abilities and/or Related Experience

• College degree, associates degree or equivalent number of college level credits preferred. Completion of HIAA, LOMA or ICA courses desirable.

• Minimum of 5 years' experience as an STD examiner or related disability experience required. One year as a LTD examiner preferred.

• Prior supervisory or management experience desirable.

• Ability to handle multiple competing priorities.

• Ability to function with limited supervision.

• Proven ability to work well in a high visibility, public oriented environment, with excellent written and verbal communication skills.

• Proven ability to effectively lead group training sessions.

• Proven ability to work with the following equipment: personal computer programs (e-mail, Microsoft Word and Excel, etc.), automated claims system. Ability to use any or all of this equipment to track, measure and improve performance.

Ability to Travel: Up to 10%

PHYSICAL REQUIREMENTS

When used in the description below, the following terms are defined as:

"Occasional": done only from time to time, but necessary when it is performed

"Frequent": regularly performed; generally an act that is required on a daily basis

"Continuous": typically performed for the majority of an employee's shift

Sitting for prolonged periods of time, frequently standing, walking distances up to one mile, bending, crouching, kneeling, reaching, occasionally lifting 25lbs, extensive typing, picking up and holding small objecting and otherwise using primarily the fingers rather than the entire hand. Employee is required to have visual acuity sufficient to perform activities such as preparing and analyzing data and figures; transcribing notes; viewing a computer terminal and extensive reading. Employee is required to have hearing sufficient to understand verbal instruction and answer telephones. Reliance Matrix will provide qualified employees with a reasonable accommodation in accordance with applicable law.

CORE VALUES

• Collaboration

• Compassion

• Empowerment

• Integrity

• Fun

The above description reflects the general details considered necessary to describe the principle responsibilities and functions of the job identified and shall not be construed as a detailed description of all the work requirements that may be inherent to this job.

Work location may be flexible if approved by the Company.

What We Offer

At Reliance Matrix, we believe that creating a more diverse, equitable and inclusive culture allows us to realize more of our potential. And we can't do this without our most important asset-you.

That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.

Our Benefits:

• An annual performance bonus for all team members

• Generous 401(k) company match that is immediately vested

• A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account

• Multiple options for dental and vision coverage

• Company provided Life & Disability Insurance to ensure financial protection when you need it most

• Family friendly benefits including Paid Parental Leave & Adoption Assistance

• Hybrid work arrangements for eligible roles

• Tuition Reimbursement and Continuing Professional Education

• Paid Time Off, volunteer days, community partnerships, and Employee Assistance Program

• Ability to connect with colleagues around the country through our Employee Resource Group program and our Diversity Equity & Inclusion Council

Our Values:

• Integrity

• Empowerment

• Compassion

• Collaboration

• Fun

EEO Statement

Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.

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