Disability Case Manager-Alight Leave Solutions-Hybrid-Jersey City, NJ

Our Story At Alight, we believe a company’s success starts with its people. Alight embraces values that come directly from our people – purposeful, human, united and growth-minded – reflecting our inclusive culture and promise that our clients expect. We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management. Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities – all within a thriving global organization. Flexible Working So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and “Top 100 Company for Remote Jobs” 6 years in a row. Great Place to Work Thanks to the work of every colleague, Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.” About the Role Disability Case Manager is responsible for administering and case managing assigned Group Short Term Disability claims. They will follow the plan provisions, state and federal guidelines, and established protocols. The CCM works jointly with other team members within STD, and LTD and Risk Management resources. Responsibilities Using most efficient and effective means of proactive outreach to obtain and/or dispense information. Involving information to and from claimants, departmental managers, physicians, HR, Payroll, or any other sources. Communicating claim status and decisions via telephone and in writing. Initiating communications to claimant, physician, and /or plan holder to obtain information, make assessment, and initial claim decision. Prioritizing and reviewing new claims to adhere to established departmental productivity. Meeting productivity requirements as established by department for handling “fast track” disability claims with limited durations. Investigating and analyzing claim information to determine coverage and benefit eligibility. Performing pre-existing condition investigation and draft adverse determination letter, if applicable. Determining disability by comparing functionality with job. Setting up claim for initial benefit approval including physician statement(s) and medical records. Following claim management procedures and identifies potential return to work, job accommodation opportunities when applicable. Utilizing claim management resources, i.e. MDA (Medical Disability Advisor), and other disability guidelines. Working with the goal of returning claimant to active work status. Assessing claim when other sources of income are received to ensure accurate offsets are applied. Recalculating benefits as needed determining under/overpayments. Requirements Demonstrate independent problem solving and decision-making ability. Able to clearly communicate claim decisions and contract language verbally and in written correspondence. Demonstrate math aptitude, ability to multitask, and analytical skills. Have 4-year college education or equivalent work/education experience. Experience of 2 years of disability claim management experience (STD), or other previous Group insurance experience. Have experience with candidate regulatory and compliance standards. Application and Interview By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight’s employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position. Alight requires all virtual interviews to be conducted on video. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations. Our commitment to Inclusion We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful. At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future. As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact View email address on click.appcast.io. Equal Opportunity Policy Statement Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans. Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodations/modifications by contacting their recruiter. Authorization to work in the Employing Country Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight. Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units. We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization. Salary Pay Range Minimum: 65,000.00 USD Maximum: 85,000.00 USD Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight DISCLAIMER: Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units. Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer. #J-18808-Ljbffr Alight Solutions