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POST DATE 9/17/2016
END DATE 12/1/2016
JOB DESCRIPTIONPosition Summary:
Under general direction of a Team Manager, monitors the day to day activities of a small group of claim or leave staff handling the investigation, management, & timely disposition of disability and absence management claims (LTD, STD, FMLA, total absence tracking) within account, carrier and/or company guidelines. Responsible for day to day monitoring of a small team of claims professionals in the adjudication of LTD, STD, FMLA claims. Monitors quality and turnaround times necessary to ensure the desired service levels are met and exceeded. Provides coaching, mentoring and subject matter expertise on a daily basis for assigned team.
* Reviews work of assigned team daily to ensure that critical production processes including Performance Guarantee, Federal, State, ERISA and Operational Turnaround times and Quality norms are followed and that production and overall quality standards are upheld.
* Ensures that practices and procedures are followed by the team. This includes assuring that work flow processes are followed and procedural changes are implemented as appropriate.
* Recommends changes to operation work flow for optimal efficiency and amended as needed.
* Ensures product quality and integrity, and ensures all finished product meets or exceeds customer requirements.
* Supports and assists Team Manager, Director, AVP and VP leaders as needed.
* Maintains positive working relationships with team members, customers, and other departments.
* Communicates to Team Manager any activities or problems within assigned direct reports and area of responsibility and partners on resolution plan.
* Analyzes, approves and authorizes assigned claims and determines benefits due based on a client s disability and total absence plans.
* Manages disability claims according to plan ensuring compliance with duration and guidelines.
* Assists in facilitating the implementation, continuous improvement and integration of all disability and absence management programs/processes within the unit.
* Maintains up-to-date knowledge of industry trends in integrated disability and absence management.
* In direct communication with claimants and clients on the claims process via phone or written correspondence. Requests supporting documentation required to process claims.
* Coordinates investigative services and may need to provide information on claims being appealed.
* Monitors operations & assigned staff and recommends, when necessary, changes in methods, procedures, structure, & additions or changes in personnel to secure optimum utilization of resources.
* Counsels team members on educational & job opportunities which will enhance their career development, & keeps staff informed of current issues, changes, & new developments in the department & company by conducting periodic meetings.
* Assists in establishing department objectives supportive of corporate and strategic objectives.
* Proactively identifies potential fraudulent activities within claim file reviews and take appropriate action to review and assess issue through to resolution to ensure all claims approved are eligible for the benefits due.
* Keeps direct Team Manager informed verbally & in writing of activities & problems within assigned area of responsibility.
* Performs other related work as required or requested.
* May participate in sales presentations and meetings with prospects and current accounts in support of corporate revenue objectives as needed; including onsite tours or at client location.
* Will be required to manage a reduced claim or leave block of complicated/escalated claims as needed.
* Supports 4-5 Disability Benefit Specialists or Leave Specialists day to day work.
* Upholds the Crawford Code of Conduct.
* High School Diploma or GED.
* Two or more years of progress experience as a FMLA coordinator or STD/LTD claims handler, or the equivalent, demonstrating the technical expertise to handle the most complex cases with a high degree of judgment & discretion.
* Demonstrated ability to establish critical relationships within the disability and leave organization and with external client partners.
* Exceptional communication skills, change management skills, and customer focus.
* Excellent oral, written, and presentation skills.
* Bachelor's degree.
In addition to a competitive salary, Crawford offers you:
* Career advancement potential locally, nationally and internationally. Crawford & Company has more than 700 locations in 70 countries
* On-going training opportunities through every stage of your career
* Strong benefits package including matching 401k; health, dental, and life insurance; employee stock purchase plans; tuition reimbursement and so much more.
Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V
Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.