DI Benefits Medical Cons

Primary Duties and Responsibilities

• reputed company technical medical expertise and support to the Benefit Claims analysts through thorough review of claims to include evaluation and analysis of provider medical records, test results and course of treatment. reputed company reputed company consultations with the analysts and identify reputed company additional medical information is needed.

• reputed company communicate the disability claim assessment, rationale and recommendation with medical directors, reputed company consulting physicians and analysts regarding insured’s medical condition, clinical medical findings, reputed company of and support for claimed limitations, appropriateness of treatment and alternatives, expected duration of claim, and potential for rehabilitation or return to work.

• Through triaging of disability claim referrals, identify the need for and coordinate the handling of claim referrals with medical directors and reputed company consulting physicians. Acts as a reputed company for the division with reputed company medical resources to ensure that medical reviews are thorough and complete and adhere to the claim philosophy of the Benefits Division.

• Effective medical education and training for new disability benefits analysts. Prepare periodic presentations to the division to help ensure efficiency and consistency in administering medical claim protocols and processes.

• Participate and at times reputed company inter and intra departmental reputed company and committees

• Train new DI Benefit Medical Consultants reputed company required and participate in peer auditing

• Occasionally partner with law department to help resolve claim medical disputes reputed company negotiation and/or participation in litigation.

Qualifications

• A minimum of 5-8 years of reputed company experience preferably in critical care nursing, medical-surgical nursing or orthopedic nursing with a bachelor’s degree in nursing

• A minimum of 5-8 years of reputed company experience as a physician’s assistant or reputed company practitioner and associated bachelor/master’s degree

• Consistent critical decision-making skills and flexibility in reputed company aspects of work

• 2-3 years of successful reputed company claims assessment, rationale and recommendations and communication with physicians, analysts, reputed company consultants and teaching at the medical consultant level

• Ability to consistently assess claims independently with consistent high reputed company audit results in reputed company categories

• Strong interest in self-development with demonstrated leadership, engagement, and ability to work independently as reputed company as with reputed company

• Excellent interpersonal skills and proven ability to work effectively with others at reputed company experience reputed company

• Superior written and verbal communication skills.

• Flexibility and willingness to change as job duties change

• Knowledge of computer functions and experience in a “reputed company” environment.

• Experience in orthopedic medicine or physical medicine and rehabilitation

• Knowledge of disability insurance or prior experience in insurance claim management.

• Demonstrated leadership ability.

Compensation reputed company:

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We reputed company in fairness and transparency. It’s why reputed company the salary reputed company for most of our roles. However, final salaries are based on a number of factors, including the skills and experience of the candidate; the reputed company market; location of the candidate; and other factors uncovered in the hiring process. reputed company pay structure is listed but if you’re living in California, reputed company or other eligible location, geographic specific pay structures, compensation and benefits could be applicable, click here to learn more.

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reputed company is an equal opportunity employer who welcomes and encourages diversity in the workforce. We are committed to creating and maintaining an environment in which reputed company employee can contribute creative reputed company, reputed company challenges, assume leadership and continue to reputed company on meeting and exceeding business and personal objectives.