Disability Case Manager Job Description
Disability case manager
provides a timely and thorough review of Worker’s Compensation, Short Term Disability, FMLA, and ADA claims and makes professional determinations.
Disability Case Manager Duties & Responsibilities
To write an effective disability case manager job description, begin by listing detailed duties, responsibilities and expectations. We have included disability case manager job description templates that you can modify and use.
Sample responsibilities for this position include:
Knowledge of ERISA, Fair Claims Practices Model Act, privacy regulations, punitive damages statues and state and federal laws governing group insurance the Family Medical Leave Act and state leave laws
Knowledge of ERISA, Fair Claims Practices Model Act, privacy regulations, punitive damages statues and state and federal laws governing group insurance and state leave laws
Assist, as needed, in the Family Medical Leave Act (FMLA) approval process as it relates to serious health condition certification and communication
Make additional contacts to obtain information (doctor, manager)
Process short term disability suspension due to lack of or insufficient information
Works with Disability Case Management Nurses and Physician Reviewers to review complex/questionable claims
Accurately setting up new short term disability claims
Resolves complaints, problems, and coverage questions which have been escalated through the Sr
Works with Disability Case Management Nurses, Physician Reviewers, and and Vocational Rehab Counselor to review complex/questionable claims
Discussion of disability claims with claim managers
Disability Case Manager Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Disability Case Manager
List any licenses or certifications required by the position: CDMP, LOMA, FMLA, IIBA
Education for Disability Case Manager
Typically a job would require a certain level of education.
Employers hiring for the disability case manager job most commonly would prefer for their future employee to have a relevant degree such as University and Bachelor's Degree in Education, Management, Nursing, Psychology, Human Services, Counseling, Social Work, Healthcare, Business/Administration, Health
Skills for Disability Case Manager
Desired skills for disability case manager include:
Disability products would be an asset
Our business and products
Positive engagement with our customers
Your interests opening up a wide variety of career paths within Sun Life
CRFA
FEHA
FMLA
PDL and workers' compensation
Company products and services
ERISA
Desired experience for disability case manager includes:
Bachelor's degree with a minimum 3.0 cumulative GPA
Associate’s Degree and at least two years of progressively responsible practical experience, to include experience in a customer service environment
Thorough knowledge of claims investigation techniques the medical and legal aspects of a claim
At least 2 years experience (prefer 3 years) in claims or customer service preferably in the managed care or healthcare insurance industry
Professional certification as Rehabilitation Counselor (CRC) and a Master's Degree in Vocational Rehabilitation
Solid working knowledge of computers, Outlook, MS Word
Disability Case Manager Examples
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Disability Case Manager Job Description
Job Description Example
Our company is growing rapidly and is looking for a disability case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for disability case manager
- Understands and is able to articulate customer’s perspective
- Facilitates relations with and between Claim Managers, business partners, and customers to develop claim strategies and facilitate a safe return to work
- Collaborates with health care providers and ill/injured employees to promote accountability for the appropriateness and status of treatment plan and length of disability
- Acts as a medical resource person for staff
- Provide services to clients which could include eligibility assessment and intake for Oregon Supplemental Income Program (OSIP), Presumptive Medicaid, SNAP, and the Oregon Health Plan
- Assess client needs and risk status through home visits, phone calls, and connecting them with resources
- Develop comprehensive, client-centered care plans
- Paperwork, paperwork, and more paperwork! Plus quite a bit of data entry
- Communicate with claimants, employers and various medical professionals regarding the ongoing management of Short Term and Long Term disability claims
- Negotiate settlement within authority limits
Qualifications for disability case manager
- Committed to meeting the expectations of internal and external customers
- Able to solve problems, deal with concepts, and utilizes analysis, experience and judgment to make effective decisions
- Demonstrates the ability to function as an individual and a team member
- Medical/Surgical Nursing Occupational Health Nursing
- Working knowledge of physical job analysis and job description essential functions
- Functional understanding of Ergonomics and worksite modification
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Disability Case Manager Job Description
Job Description Example
Our innovative and growing company is hiring for a disability case manager. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for disability case manager
- Applies the appropriate contractual provisions, legal guidelines, case management resources, claim procedures, concepts, principles, and protocols to manage claims to the appropriate outcomes
- Communicates with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of STD and leave benefits
- Makes initial and ongoing benefit decisions and approves or denies benefits within established guidelines
- Evaluates and refers appropriate claims to risk management resources such as Vocational Rehabilitation, Managed Care, Fraud, Social Security, Second Opinion and Subrogation
- Serves as primary contact for customer inquiries and participates in meetings to review claim and leave decisions, and educate employer on program administration
- May be assigned to provide guidance and mentoring to others and projects assigned at manager's discretion
- Setting up and managing new and recurrent short term or WSIB disability claims
- Conducts investigations to determine whether or not to accept liability and to what degree
- Updates and accurately documents system and claim files on actions taken
- Conducts initial and ongoing investigations to determine whether or not to accept liability
Qualifications for disability case manager
- Demonstrated group presentation skills to instruct, inform and persuade
- Basic understanding of regulatory requirements, bargaining agreements and workplace safety principles
- Creative, innovative, self-directed, works well in a team environment
- 3 years of case management work experience
- A Bachelor's Degree or equivalent and 5+ years relevant experience
- Analytical skills to gather information, analyze facts and make recommendations based upon information collected
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Disability Case Manager Job Description
Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of disability case manager. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for disability case manager
- Update associates’ FMLA data to track lost days
- Coordinate activities related to medical management injury/illness cases under the guidance of corporate medical directors (MD’s)
- Coordinate the accommodation process for client departments according to the ADA Regulations
- Coordinate Drug and Alcohol testing as needed and follow-up management of cases
- Establish and maintain documentation (electronic database and hard copy) of medical treatment and conditions on employees
- Communicate clearly and timely with management, employees, medical director, and fellow Disability Management team members on related activity of injured or ill employees
- Assist with Workers’ Compensation activities including investigation, coverage determination, company defense, and approval of medical treatment and payment
- Accountable to Disability Management Team for support and team work in accomplishing team goals and performing team services
- Accountable to Medical Director, Company Management, and Employees for services provided
- Assist Disability Case Managers (DCM’s) with claim action plans
Qualifications for disability case manager
- Extensive knowledge of Employee/Labor Relations practices and Disability and Workers Compensation Laws
- Negotiation skills for the settlement of claims
- Knowledge of Disability Claims
- Disability and/or Leave experience preferred
- Advanced knowledge of federal and state leave of absence laws, case management practices
- Analytical skills to gather information, analyze facts and make recommendations based upon information collected utilizing software (Excel, ) and proprietary claims applications
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Disability Case Manager Job Description
Job Description Example
Our company is hiring for a disability case manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for disability case manager
- Assist in the daily review of each DCM’s Action Items
- Sends Letters or Forms as needed
- Communicate with claimants, employers and various medical professionals regarding the ongoing management of Long Term disability claims
- More than 50% of your workload will support clients whose preferred language is Cantonese
- More than 50% of your workload will support clients whose preferred language is Russian
- Review group contract provisions and submit medical information in order to identify discrepancies and inconsistencies when assessing disability benefit eligibility
- Setting up and managing new and recurrent short term, long term or WSIB disability claims
- Reviewing new and ongoing complex Short-Term disability and critical illness claims
- 50% of your workload will support clients whose preferred language is American Sign Language.They are mainly located in a specialized care facility for the deaf, hard of hearing and deaf-visually impaired
- 1 to 2 years of experience in claims or customer service preferably in the managed care or healthcare insurance industry
Qualifications for disability case manager
- Knowledge of insurance, medical terminology, and case management in same or similar discipline a preferred
- Bachelor's degree or equivalent experience plus a minimum of 1 year of disability claim experience
- Managed care/utilization review experience
- Knowledge of legal liability, insurance coverage or medical terminology preferred.Effective interpersonal, analytical and negotiation abilities required
- Knowledge of insurance, medical terminology and case management in same or similar discipline helpful, but not mandatory
- High School diploma plus 4 or more years of business experience with some exposure to insurance products required
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Disability Case Manager Job Description
Job Description Example
Our growing company is hiring for a disability case manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for disability case manager
- Interacts frequently with faculty/instructional staff and student service areas of the College on the provision of accommodations on the caseload
- Facilitates student referrals to other campus offices or community agencies
- Assists with or participates in meetings, trainings, orientation and other campus events
- Attends divisional or college meetings as required with the Director
- More than 50% of your workload will support clients whose preferred language is Vietnamese
- Effectively determine metrics Required to measure effectiveness of leave management process
- Review Associate employment date, leave history, and benefit elections to determine eligibility and/or discrepancies, forwarding notification to Associate
- Manage Associate data including, but not limited to, updating Associates’ FML days, correcting eligibility, entering return to work dates
- Compile metrics that can be used to evaluate the effectiveness of leave management policy, procedures and processes
- Manage Associate data including, but not limited to, updating Associates’ FML days, correcting eligibility, entering return to work dates, etcCompile metrics that can be used to evaluate the effectiveness of leave management policy, procedures and processes
Qualifications for disability case manager
- Minimum of 2 years occupational case management or medical surgery experience preferred
- Case Management experience, Certified Case Manager (CCM) accreditation, and/or Certification in Occupational Health Nursing (COHN) preferred
- Working knowledge of disability management practices, workers compensation laws and policies such as Family Medical Leave Act, American’s with Disability Act, 1973 Rehabilitation Act-Section 503, medical privacy regulations and Human Resources Management practices preferred
- Available for frequent, short notice travel within the service territory
- Working knowledge of data base systems for use in performing job (RiskMaster, PeopleSoft, ) preferred
- Experience working in disability services, evaluating documentation, determining accommodations, and promoting universal design and/or accessible technologies