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Disability Case Manager Resume Samples
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Candidate Info
11
years in workforce
7
years at this job
HS
High School Diploma
C
Health Claims Examiner / Medical Biller
Ssi/disability Case Manager
- Managed large caseload of over 200 cases which needed to be ready for attorneys at any given moment.
- Interviewed and screened claimants to determine acceptance of claim by the firm.
- Established clear lines of communication between Social Security offices, hospitals, and clientele.
- Ensured files were adequately prepared in a timely manner to meet strict Social Security Disability Hearing deadlines.
Candidate Info
16
years in workforce
4
years at this job
BA
Commerce
Disability Case Manager
Working as a Disability Case Manager at [company name], involves administering and managing Short Term Disability and Long Term Disability Claims.
- Adjudicated and managed complex short-term, long-term, appeals and seamless disability claims from initial claim to return to work within strict service level agreements.
- Assessment of client via telephone interview.
- Conducted and coordinated community programs and vocation rehabilitation efforts leading to reduction of claims experience.
- Developed an appropriate return-to-work goal with the employee and employer and provide support for the return-to-work planning process.
- Reviewed and researched the policies, agreements and legal precedents affecting disability claims.
- Liaise with medical, legal, human resources and occupational health and other health experts in the assessment of claims.
- Manage and develop excellent relations with Employees, Employers, External HR, doctors, internal Rehabilitation Consultants and Medical Coordinators to facilitate return to work focused plans.
- Prepare cost-benefit analyses of proposed budgets to validate claims management expenses
- Provided coaching and mentoring to new case managers and member of the process improvement team for the Toronto Disability department.
Candidate Info
3
years in workforce
3
years at this job
BA
Communication Processes
Complex Disability Case Manager
- Heighted observation skills by reviewing newly filed claims and ensuring all critical fields are loaded correctly
- Capitalized on interpersonal skills by communicating disability benefit information to claimants and interviewing claimants to gather more information regarding their specific claim over the phone
- Strengthened interactive skills of delivering both good and bad claim outcomes by contacting claimants to provide update on claim status
- Enhanced writing skills by drafting letters to both physicians and claimants as needed
- Developed proficiency for working with medical professionals to discuss records and diagnoses
- Facilitated meetings between assigned case managers and consulting clinical staff to help resolve claim issues
- Improved measures for developing safe and effective ways for claimants to return to work as earlier as possible
- Utilized communication skills by accurately and effectively keeping employers notified of the status of their employee's claim status and estimated return to work capabilities
- Mentored new hires following formal training to help them adjust to their new role and responsibilities
Candidate Info
15
years in workforce
2
years at this job
HS
Business
Short Term Disability Case Manager/customer Service Representative
- Managed caseload of up to 100 claims.
- Maintain comprehensive understanding of insurance policies to confirm employer and insured's eligibility for benefits.
- Review Employee Statement for any additional earnings receiving, SSI, Workmen's Compensation, Pension, Commissions, State Disability.
- Oversees policy implementation from start to finish.
- Phone interview with insured and communicates with their providers.
- Provides exceptional customer service to external and internal customers.
Candidate Info
19
years in workforce
3
years at this job
BA
Health Promotion
Disability Case Manager
- Manage 200+ caseloads for federal employees disability retirement claims
- Work with a large number of federal agencies and medical providers nationwide to facilitate case coordination
- Collect and compile supportive medical evidence, required documents, and application forms to properly build
- Coordinate and conduct application appointments
Candidate Info
16
years in workforce
2
years at this job
BBA
Bachelor of Business Administration
BBA
Bachelor of Business Administration
MS
Master of Science
Long Term Disability Case Manager
The Long Term Disability Case Manager contacts and communicates with health care providers to gather appropriate and confidential medical information related to LTD claimants in regards to their specific medical condition(s).
- Accountable for conducting interviews with claimants, clients, and physicians (via phone, mail/e-mail) to obtain confidential medical history and other income benefits, to set claim process expectations, and to answer questions during the initial claim management process. Evaluate the claim and plan to determine eligibility for LTD benefits, calculate and apply applicable offsets and taxes.
- Inquire, gather, and confirm other income benefits, including effective dates and amounts for benefits such as but not limited to State-Mandated Benefits, Social Security Benefits, Worker’s Compensation, Pension/Retirement benefits, etc. Document all actions on the claim, enter all codes in the system & input follow up tasks.
- Conduct ongoing interviews with claimants at specified intervals to certify their eligibility and gather additional information regarding their prognosis and other income benefits.
- Refer appropriate claims to Internal Resources (such as Clinical Case Managers, Vocational Rehab Specialists, etc.)
- Answer complex claim and plan questions from incoming callers. Review other Disability Case Managers Termination/Denial Letters and Recalculations. Act as a mentor and technical resource to other Disability Case Managers. Perform other duties as assigned, such as recalculating a difficult claim, reviewing and responding to claim audits from Management or the Client.
Candidate Info
18
years in workforce
3
years at this job
HS
Nursing
AS
Nursing
BS
Nursing
Registered Nurse, Disability Case Manager/qrc
- Responsible for managing assigned caseload to ensure individuals receive appropriate services in order to return-to-work timely and in the most cost effective manner
- Interview and evaluate claimants to determine degree of disability and employability in Northern Minnesota and Wisconsin
- Develops, implements, and evaluates vocational rehabilitation plans for successful case management outcomes
- Act as liaison with all parties involved in the rehabilitation process
- Works independently and collaboratively from a home based office
- Creatively able to optimize and organize time to meet deadlines
- Able to travel and work irregular hours
Disability Case Manager Resume Success Stories
