Senior Disability Claims Administrator

2 weeks ago


Maplewood NJ United States Tandym Group Full time

A long-standing company in NJ is seeking a Senior Disability Claims Administrator to support their operations in Maplewood, NJ. Please apply for more information.

Responsibilities:

  • Review applications for temporary disability benefits (TBD) claims to ensure that required information is submitted and the appropriate medical documentation is received
  • Review medical documentation for accuracy, compliance and duration of absence based on medical diagnosis for TDB claims
  • Authorize TDB claim payments in compliance with employee application, state law, collective bargaining agreement, medical diagnosis and duration of absence
  • Remain in contact with employees as required during authorized absence and ensures compliance with medical recommendations on TDB claims
  • Attempt to resolve contractual disagreements prior to a grievance being filed regarding TDB benefit determination in conjunction with contracts, policies and past practices
  • Perform other duties, as needed

Qualifications:

  • 4+ years of experience in a Disability Claims, Medical environment, and/or other Claims-related role
  • High School Diploma / GED
  • Must be able to apply state disability law to day-to-day situations and communicate the company position on each claim.
  • Familiarity with Automated Claims Management system
  • Solid investigative skills
  • Great interpersonal skills
  • Excellent communication skills (written and verbal)
  • Strong attention to detail
  • Highly organized

Desired Skills:

  • Knowledge of Medical terminology


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