Complete eligibility decisions, gather pertinent data, when necessary, from employee, employer, physician’s office or employer through outgoing calls, email, fax or other supporting systems.
- Promptly review new STD Claims and make initial & subsequent claim decisions.
- Perform discussion on health condition, RTW confirmation, return phone calls, etc.
- Update systems to accurately reflect claim status and ensure appropriate diary documentation exists
- Business recommended TAT to complete the activity within the required number of business days, specific to task types, to maintain compliance measures
- The position is expected to do end to end management including Statutory plans, Federal, Company, State and other Leave types.
- Interact with claim specialists, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician’s office
