Dearborn, Michigan

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision.  At Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, it’s a powerful combination.  It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care. 

Due to the current COVID-19 (coronavirus) pandemic, this position will require you to work remotely from your home with the expectation that you will return to a regular, in-office work environment. As we continue to monitor guidance from CDC and state officials there may be times you would need to report to the office on a monthly or quarterly basis for team meetings or engagement activities.

The Disability Care Coordinator/Senior Approver (Union Role) – DCC is responsible for the management of Disability claims for group policyholders to include investigation, documentation and authorization of payment.  The DCC also pays claims and completes minor adjustments. There is constant interaction with claimants, medical professionals, and other vendors.  DCC will handle statutory, occupational and non-occupational claims as well as claims that fall outside duration guidelines.

DUTIES AND RESPONSIBILITIES:
•    Responsible for adjudicating all STD claims in a timely manner.
•    Manage claims in accordance with company standards, which includes the Statement of Work and Client Contract Plan Language.
•    Providing excellent customer service
•    Gather clinical and confirm eligibility information to verify approved period of disability
•    Maintain awareness of the ERISA, Fair Claims Practices Model Act, privacy regulations, and state-mandated laws, and abides by them as dictated by each individual claim.
•    Actively enlist the services of support services (Physician Advisor, Vocational Rehabilitation, etc.) to assist with claim management
•    Ability to interact with treating sources to negotiate appropriate treatment plan and return to works.
•    Responsible for timely and accurate payment of Disability claims.
•    Ability to determine and withhold FICA, Federal, State and Local taxes when making claim payments. 
•    Knowledge of the necessary agreements to determine and withhold Support Orders, Garnishment, Bankruptcy, Federal and State Levies.
•    Determine and calculate appropriate offsets.
•    Correspond via letter and telephone with employee, physicians, employers, hospitals, rehabilitation and other vendors to obtain claim information.
•    Is responsible for mailing appropriate state program forms as well as required company disability forms to the employee.
•    General claims support duties to include telephone coverage.
•    Other duties as assigned.

 

Qualifications

QUALIFICATIONS:
•    Preferred: BA and/or equivalent work experience
•    Comprehensive knowledge of group insurance principles and practices
•    Proficient contractual understanding of group Disability product
•    Basic computing and keyboarding skills required with proficiency in Word and Excel
•    Excellent oral and written communication skills including active listening;
•    Ability to make timely and effective decisions
•    Ability to work independently as well as working effectively in a team environment
•    Successful completion of certification requirement for this position
•    Satisfactory completion of job related proficiency test

KNOWLEDGE/EXPERIENCE:
    Provides superior, professional and courteous service to our customers.
    Provides timely and accurate resolution of inquiries and issues regarding claim payment regarding benefits, policies, and contracts.
    Handles complex calls and situations by taking ownership of issues to ensure timely resolution or follow-up.
    Conducts research and resolves issues.
    Participates in special projects assigned.
    Demonstrates full competence in own work area.
    Makes significant contribution to work team.
    Performs other duties as assigned.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Dearborn, Michigan

As one of America’s largest health benefits companies, we at Anthem have a profound appreciation for service. Our organization proudly supports our Nation’s active, reserve, and veteran military service members and their spouses.

This is an exciting opportunity to advance your life and career, while still protecting and serving others. Come see for yourself why Anthem is recognized as a Top Employer by GI Jobs and among the “Best of the Best: Top Veteran Friendly Companies” by US Veterans Magazine.

Who We Are Looking For 

Anthem, Inc. is seeking military veterans across the country who bring a deeply rooted skillset that includes team-oriented approaches to problem-solving, demonstrations of leadership and an overall commitment to the mission of the organization.  If you are a military veteran or military veteran spouse, Anthem, Inc. is looking to hire you.

Join Anthem's Military and Veteran Talent Network: https://anthemcareers.ttcportals.com/pages/military

Should I Apply?

Are you a transitioning member of the military or a military veteran who is looking for a civilian career that provides opportunities for growth and career advancement?  Anthem, Inc. is currently looking for job seekers with  Operations experience.  If you are interested in a career in one of these fields, check out our current open positions to the right for more information and to apply today!

What Happens After I Apply?

Once you click ‘Apply Now’ on an Anthem, Inc. job posting, you will be re-directed to fill out an application on Anthem's career page.  In order to be considered for next steps, please complete the application on Anthem's career page and make sure you have an updated resume uploaded to your RecruitMilitary profile.  Once Anthem, Inc. reviews your resume and profile, a recruiter will reach out to provide you with more information and to schedule you for an interview.

How to Win An Interview

1.     Review the job description for the specific position you are applying for.

2.     Review the company website. Know their mission and values. What do they do? What are their products?

3.     Prepare a few questions to ask on your interview.

4.     Prepare to discuss your military or civilian background and how it relates to the position. 

5.     Check out our Resources tab for resume guidance, interview prep and more!

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