Exl Service

Disability Claims Associate

US-FL-Tampa
ID
2018-4967
Type
Regular Full-Time
Job Code
DJOB

Overview

EXL (NASDAQ: EXLS) is a leading operations management and analytics company that designs and enables agile, customer-centric operating models to help clients improve their revenue growth and profitability. Our delivery model provides market-leading business outcomes using EXL’s proprietary Business EXLerator Framework™, cutting-edge analytics, digital transformation and domain expertise. At EXL, we look deeper to help companies improve global operations, enhance data-driven insights, increase customer satisfaction, and manage risk and compliance. EXL serves the insurance, healthcare, banking and financial services, utilities, travel, transportation and logistics industries. Headquartered in New York, New York, EXL has more than 26,000 professionals in locations throughout the United States, Europe, Asia (primarily India and Philippines), South America, Australia and South Africa. For more information, visit www.exlservice.com.

 

As a Disability Claims Associate, you will perform medical retrieval and summarization. You will need the knowledge and skills to conduct thorough investigations of disability claims. This is a fast-paced job where attention to detail counts. The Disability Claims Associate has direct impact on claimant health, well-being and sense of security. The ability to make and effectively communicate decisions within tight time frames, while integrating knowledge of medical conditions and customer contracts is an integral part of success in this role.

Responsibilities

Job Responsibilities:

Operations: Ensure a positive customer experience. Maintains in-depth knowledge of customer needs. Promotes and maintains a positive, professional image of EXL. Participates in special projects as directed by Leadership.

Issue Resolution: Investigates and resolves customer issues as required.

Communication: Excellent written and verbal communication is essential.

As a Disability Claims Associate, You Are Responsible for:

  • Preparation of claims for medical retrieval, summarizations, vendor rehabilitation (return to work) which include short-term, long-term and rehabilitation disability. The success of this work will be through capturing medical information, applying appropriate contractual provisions (scope of work), following legal guidelines, and leveraging expert resources.
  • Having direct communication with claimants, employers, and various medical professionals to gather information regarding the claim for, short-term, long-term and rehabilitation disability benefits.
  • Support and promote all integration initiatives.
  • Handle potentially high levels of inbound correspondence from claimants and medical professionals. There correspondences maybe via written, faxed and/or emails response of the request for medical records.
  • Work directly with clients to facilitate return to work assessments.
  • Network with both claimant and physicians to gather medical records, labs, diagnostic test and any other pertinent medical requests for review and ongoing evaluation of medical information.
  • Delivery of clients expectations outlined in the scope of work (SOW).
  • Adherence to standard timeframes for processing mail, tasks and outliers as outlined in the scope of work.
  • Understand Operations and Corporate Compliance, Policies and Procedures and Best Practices.
  • Stay abreast of ongoing trainings associated with role and business unit objectives.
  • Respond to all telephonic and email inquiries within client service protocols (SOW) in a clear, concise and timely manner.
  • Other duties as outlined by leadership.

Qualifications

Qualifications:

 

Disability claims processing.  required

Strong interpersonal relationships. required

Demonstrated reasoning skills. required

Understanding of Medical Terminology. required

Understanding of Independent Medical Examination process. preferred

 

Proven ability to organize and prioritize; demonstrated success in multitasking and managing multiple, competing priorities.

Strong ability to communicate at all levels with clarity and precision, both written and verbal.

Ability to adapt in a changing work environment.

Computer skills, including MS Word, Outlook, Share Point, etc.

 

 

Education:

 

Graduate of a Licensed Practical Nursing School required

Active Florida Nursing License  

or

Graduate of a Nursing Assistant School required

Active Florida Nursing Assistant Certification

or

Graduate of a Medical Assistant School required

Active Florida Medical Assistant Certification (Certified Medical Assistant – CMA)

 
Work Experience Requirements:

 

Medical claims retrieval and summarization required

2+ years in a medical office or hospital experience preferred but not required

EEO Statement

EEO/Minorities/Females/Vets/Disabilities

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