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Clinical Reviewer in Elkridge, MD at KEPRO

Date Posted: 11/5/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Elkridge, MD
  • Job Type:
  • Experience:
    5 to 7 years
  • Date Posted:
    11/5/2018

Job Description

Absence Management Disability Case Manager - Clinical Reviewer

KEPRO Absence Management Team is seeking a full-time Disability Case Manager to support our Family Medical Leave Administration (FML) Product.  DCM is responsible for processing FML medical certifications to determine if employee is eligible for FML leave under federal regulations and making leave determination based on medical guidelines. Position is Monday through Friday.

Primary Responsibilities

  • Maintain a comprehensive knowledge of Family Medical Leave Act (FMLA) and related laws in all 50 states to efficiently administer our customers' FMLA and related policies.
  • Review medical certification documents under federal & state regulations to determine eligibility for protected leave of absence.
  • Meet production and quality goals set by the Absence Management Department.
  • Provide accurate, professional and timely responses to communications from internal and external clients.
  • Serve as an internal reference to the team for certification requirements and processing.
  • Contact Medical Providers to obtain and establish medical facts supporting the need for leave.
  • Correspond with clients regarding leave status and assist with decision-making.
  • Compose and send client-specific letters and emails regarding final decisions.
  • Provide innovative ideas that can support the ongoing growth of the Absence Management Department.
  • Support management with special projects as necessary.

 

Skills

  • Demonstrate reliable and consistent attendance and is dependable.
  • Effective written and verbal communication skills.
  • The ability to think critically by gathering information, evaluating options and implementing the best solution.
  • Focus on achieving goal-oriented results.
  • Can make independent decisions and solve problems on your own.
  • Strong attention to detail, thoroughly executing tasks with accuracy and precision.
  • Efficient task management and ability to prioritize multiple projects.
  • Excellent customer services skills required.

Job Qualifications

  • Active RN license, LPN, or Master’s Degree in Behavioral Health or Human Resources Management.
  • 5-7 years of clinical or professional experience preferred.
  • Proficient in Microsoft Office Suite, Adobe, and web navigation.
  • Previous experience in absence management including thorough knowledge of Family Medical Leave Federal and State regulations and experience reviewing short-term disability claims, preferred.
  • Stable work history required.