Exl Service

  • Disability Claims Nurse

    Job Location US-REMOTE
    ID
    2018-5786
    Group
    Operations Management (+HI)
    Type
    Regular Full-Time
  • Overview

     

    Why join EXL? 

    At EXL, we’re more than just an analytics, operations management, and technology Company. We focus not only on our outstanding Team Members, but on our growing industry as well.

    Headquartered in NYC, EXL has more than 27,000 professionals situated in locations throughout the United States, Europe, Asia, Latin America, and South Africa.

     

    Our EXL Team Members receive the benefit of:

    Valuable Compensation Package:

    • Competitive Wages
    • Work-Related Expense Reimbursement
    • Annual Discretionary Bonuses
    • Team Member Referral Bonuses

    Comprehensive Health & Welfare Benefits:

    • Group Medical, Dental and Vision Benefits
    • Flexible Spending Accounts and Health Savings Accounts
    • Generous Paid Time Off, Sick Days and Holiday Pay
    • Group Life Insurance, LTD and 401k Retirement

    Inviting Culture & Team-Oriented Philosophy:

    • Exciting Work Environment
    • Casual Dress Code
    • Monthly Team and Company Events
    • Team Member Appreciation Awards
    • Remote, Home-Based Opportunities
    • Upward Mobility Opporunities  

     

     

    As a Disability Nurse Subject Matter Expert (SME), you will perform the medical retrieval, summarization and low complexity nurse review. 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 Nurse SME will have direct impact on claimant health, well-being and sense of security. This person must have the ability to make effective decision and communicate decisions within tight time frames, while integrating knowledge of medical conditions, customer contracts, and corporate compliance are critical for success.

    Responsibilities


    Issue Resolution: Investigates and resolves issues as required.


    As a Disability Nurse Claims Reviewer, You Are Responsible for:
    • Having direct communication with various medical professionals to gather information regarding short-term, long-term and rehabilitation disability benefits.
    • Support and promote all integration initiatives.
    • Handle potentially inbound correspondence from medical professionals. There correspondences maybe via written, faxed and/or emails response of the request for medical records.
    • Work 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

    • Long Term Disability, Short Term Disability, and Low Complexity Nurse Review.
    • Strong interpersonal
    • Demonstrated analytical and clinical critical thinking skills.
    • 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.
    • Advanced technical/computer skills, including MS Word, Excel, PowerPoint, Share Point, etc.

     

    Education:

     

    US Registered Nurse with current, valid unrestricted licensure

     
     
    Work Experience (preferred):
     

    Work experience in Long Term Disability, Short Term Disability and Vocational Rehabilitation

     

     

    EEO Statement

    EEO/Minorities/Females/Vets/Disabilities

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