Anthem, Inc. Disability Case Manager in Atlanta, Georgia
SHIFT: Day Job
Disability Case Manager Days: Monday- Friday Locations: Atlanta, GA., Portland, ME.
Disability Case Manager responsible for reviewing, investigating, and documenting Short Term Disability (STD) claims to determine eligibility for benefits. Primary duties may include, but are not limited to: • Reviews claim materials against disability policy coverage and duration guidelines to determine liability and adjudicates the claim. • Gathers clinical and eligibility information to verify approved period of disability. • Works with Disability Case Management Nurses and Physician Reviewers to review complex/questionable claims. • Maintains up-to-date knowledge of company products and services. • Knowledge of ERISA, Fair Claims Practices Model Act, privacy regulations, punitive damages statues and state and federal laws governing group insurance. • Administers disability income payments on behalf of group policyholders. • Obtains necessary agreements to determine FICA, and Federal and State income tax requirements. • Monitors and acts on potential benefit reductions under contract fraud, misrepresentation, and malingering. 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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.
• Requires a High School diploma or GED; 2 years of experience in Disability Case Management, up to 2 years’ experience in claims or customer service preferably in the managed care or healthcare insurance industry; or any combination of education and experience, which would provide an equivalent background. BA/BS degree preferred.