HR Short Term Disability Claims Coordinator
The posted compensation range of $22.35 - $30.73 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
The primary responsibility of this role is to manage and monitor the Short Term Disability and/or Statutory Disability claims processes to ensure timely and accurate claim decisions are made and administered on behalf of the organization.
Responsibilities
*This is a remote opportunity
- Manage the overall caseload of STD, Statutory Disability and/or Family & Medical Leave Act (FMLA) claims while remaining in full compliance with regulatory requirements.
- Evaluate claimant eligibility (via information received from claimant and attending physician) to determine the validity and expected length of a claim (whether to return, pend, deny or pay claims).
- Follows and ensures claims processing is consistent with applicable policies, regulations, procedures and department guidelines for disability claims.
- Documents the claims system in an accurate and comprehensive manner while maintaining maximum levels of efficiency and confidentiality.
- Prepare and articulate written and verbal communication to assorted internal and external sources.
- Able to recognize overall process insufficiencies, cost reductions, and opportunity for processing enhancements.
- Responsible for managing the STD claims team but is not limited to the following:
- Support overall claims team by creating a positive work environment, consistently maintain professionalism and integrity, demonstrate a dedication to excellence, and actively take steps to foster high morale.
- Ensure case workloads are appropriately balanced among team members along with providing team members with the resources needed to succeed.
- Provide technical expertise and direction to team members on claims adjudication for STD.
- Facilitate the transition from STD to Long Term Disability (LTD), in accordance with the timeline, process, and data requirements as set for between CommonSpirit Health and the LTD insurance company.
- Process increasingly complex assigned claims for payment or denial in accordance with established procedures and guidelines, in a timely manner and meeting departmental quality and production standards.
- Obtain needed claim information by communicating effectively with internal and external stakeholders verbally and in written form while maintaining a professional demeanor in all interactions.
- Provide customer service to internal and external stakeholders and recognize what needs to be completed to meet customer needs. Demonstrate flexibility and responsiveness to customers.
- Perform other related duties and activities as required.
The job summary and responsibilities listed above are designed to indicate the general nature of the work performed within this job. They are not designed to contain or be interpreted as a comprehensive inventory of all job responsibilities required of employees assigned to this job. Employees may be required to perform other duties as assigned.
Qualifications
- Bachelor's Degree or equivalent work experience (4 years of experience in lieu of Bachelors)
- Extensive knowledge of the leave requirements and other legal protections afforded by the FMLA, ADA, and other applicable laws.
- Experience in Short-Term Disability claims that directly align with the specific responsibilities for this position
- Excellent organizational skills and attention to detail.
- One year experience with disability/leave of absence claims preferred.
- Ability to manage confidential and sensitive employee information and adhere to strict data privacy standards.
- Comfortable working in a high-energy, quickly changing and demanding environment
- Excellent verbal and written communication skills.
- Strong attention to detail and organizational skills.
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
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Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
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Equal Opportunity
CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.