Reviews disability claims to identify appropriate candidates for vocational rehabilitation services. Refers candidates to case managers who assist with job placement and provision of rehabilitation services. Identifies occupations and assesses employability.
Duties and Responsibilities:
Reviews newly approved long term disability claims promptly to determine whether claimants may be appropriate candidates for rehabilitation services.
Reviews any other assigned disability claims to determine whether claimants may be appropriate candidates for rehabilitation services. Monitors and follows up as necessary.
Refers appropriate candidates to a provider of rehabilitation services to determine whether such services might enable the claimant to return to the workforce.
Actively manages all active rehabilitation cases to ensure that rehabilitation services are provided in an efficient and cost-effective manner.
Assists Claims Department personnel with the identification of a claimants occupation as needed.
Provides advice to policyholders on worksite modification as needed.
Determines which occupations a claimant has the ability to perform based on any applicable restrictions and limitations and/or that claimants education, training and experience or as required under the applicable policy.
Stays abreast of any changes in the applicable laws, regulations, resources, software, etc.
Monitors and follows up on claims which may not have originally been identified as having rehabilitation potential as appropriate.
Periodically reports on rehabilitation activities.
May work with affiliated companies to achieve corporate results.
Assists in marketing and new product development activities as requested.
May testify in legal proceedings.
All other duties as assigned.
Education, Qualifications and Experience:
Related Bachelors Degree required. Masters Degree, preferably in Rehabilitation or a closely related field highly preferred. CRC certification preferred.
Minimum of four (4) years of experience in the provision of rehabilitation services or in the management of the provision of those services.
Experience with the processing of insurance claims desirable. Experience with the handling of long term disability claims or integrated disability claims helpful.
The ability to function with minimal supervision.
Excellent verbal and written communications skills.
Proven ability to work with the following equipment: P.C.(including Word and Excel), telephone, fax machine, calculator.
Prior experience using an automated claim system desirable.
Some travel may be required.