DI Benefits Medical Cons

Primary Duties and Responsibilities Provide technical medical expertise and support to the Benefit Claims analysts through thorough review of claims to include evaluation and analysis of provider medical records, test results and course of treatment. Provide timely consultations with the analysts and identify when additional medical information is needed. Clearly communicate the disability claim assessment, rationale and recommendation with medical directors, outside consulting physicians and analysts regarding insured’s medical condition, clinical medical findings, significance of and support for claimed limitations, appropriateness of treatment and alternatives, expected duration of claim, and potential for rehabilitation or return to work. Through triaging of disability claim referrals, identify the need for and coordinate the handling of claim referrals with medical directors and outside consulting physicians. Acts as a liaison for the division with all medical resources to ensure that medical reviews are thorough and complete and adhere to the claim philosophy of the Benefits Division. Effective medical education and training for new disability benefits analysts. Prepare periodic presentations to the division to help ensure efficiency and consistency in administering medical claim protocols and processes. Participate and at times lead inter and intra departmental projects and committees Train new DI Benefit Medical Consultants when required and participate in peer auditi