Michelle Atkinson

• Provides technical direction to claim analysts on claims adjudication for Short Term Disability

• Conducts regular quality assurance reviews of claim files to ensure all claims processing adheres to company policies, industry regulations, and legal requirements

• Ensures claims processing is consistent with applicable policies, regulations, procedures and department guidelines for disability claims

• Collaborates with the training and onboarding team to document new hire progress and determine readiness for authority releases

• Conducts regular development meetings with staff to facilitate achievement of their professional development goals
• Collaborates with leadership team to document and drive goal-setting initiative for floater staff

• Accurately evaluate short-term disability claims by reviewing medical documentation, conducting interviews, and assessing eligibility based on company guidelines.
• Serve as the main point of contact for claimants, providing empathetic and informative support throughout the claims process
• Ensure that all claims processing adheres to company policies, industry regulations, and legal requirements
• Maintain comprehensive and organized claim records, including medical reports, correspondence, and claimant information
• Effectively communicate claim status, decisions, and next steps to claimants, medical professionals, and internal teams
• Collaborate with internal teams to address complex claim issues, and work towards solutions that benefit both the claimant and the company.

• Monitors work of examiners for compliance with Social Security Administration and State Medicaid eligibility guidelines and agency policy and procedures such that all examiners perform at a successful level
• Identifies, traces and documents situations that require corrective intervention, up to and including disciplinary action
• Conducts unit training and one-on-one examiner training sessions, and presents information that is clearly understood and appropriate to the audience
• Provides customer services to claimants applying for Social Security Disability and/or Medicaid
• Supervises disability examiners, medical consultant, psychological consultant and office assistants

• Conduct comprehensive reviews of disability claims, including medical records, supporting documentation, and claimant interviews
• Apply Social Security Administration (SSA) guidelines and regulations to assess claimants' eligibility for disability benefits
• Collaborate with healthcare professionals to understand and interpret medical evidence to make informed decisions.
• Maintain accurate and organized records of claim assessments, decisions, and communications with claimants and medical experts.
• Effectively communicate claim decisions to claimants, legal representatives, and other relevant parties in a clear and compassionate manner.
• Ensure compliance with SSA policies and procedures, conducting reviews to maintain the highest standards of accuracy and consistency.