Disability Case Mgr Ld (Atlanta, GA or Worhington, OH Claims Cen - (US-GA- Atlanta - 39901)

Minimum Education: Tech School
Job Type: Full Time
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WellPoint is the nation's leading health benefits company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to be the most trusted choice for consumers and a leader in affordable quality care with an unyielding commitment to meeting the needs of our diverse customers.

Investigates and documents Short/Long Term Disability claims for group policyholders. Typically handles non-statutory, non-occupational claims that are within duration guidelines. Administers disability income payments on behalf of group policyholders. Gathers clinical and eligibility information to verify approved period of disability. Reviews claim materials against STD/LTD disability policy coverage. Determines liability and adjudicates the claim. Works with Disability Management nurses, and Physician Reviewers to review complex/questionable claims. Obtains necessary agreements to determine FICA, and Federal and State income tax requirements. Review ongoing disability claims to determine WellPoints continued Liability. Monitors and acts on potential benefit reductions under contract fraud, misrepresentation and malingering. Provides testimony involved in depositions in contested claims. Mails appropriate State program forms to employee.

Skills:
Strong written, oral and interpersonal communication skills. Good analytical and PC skills. Good problem-solving skills. Uses independent judgement and works under general directions. Expierence in Disability a must. Experience using ALICS preferred. Experience managing disability claims required. Knowledge of contractual interpretation required. WellPoint is ranked No. 1 among health insurers on Fortune Magazine's annual list of America's Most Admired Companies and has been named as one of the Top 50 Companies for Diversity by DiversityInc Magazine.

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