claims examiner

entry level sales representative

financial management specialist

claims examiner ii

server

Matrix Absence Management

A typical day at work:

Come in, check email, make phone calls, look at what needs attention first, process claims, review medical, meet with the boss about something, meet with the nurse about something, chat with co-workers, collaborate, discuss, and make decisions on disability and FMLA claims, respond to emails, confirm surgeries took place, check the mail, the fax machine, notify employee's and employers of decisions, via email, phone call, and by letter. write the denial letter if denied, write the approval letter if approved, provide customer service.

What was learned:

How to type fast, write professional letters, how to work with many different personalities in the co-worker setting, what key words too look for in the medical records, durations on what is and is not normal for certain surgeries, FMLA rules and regulations, quality control, multitasking, and attention to detail, all while maintaining a professional and respectable approach to anything and everything that could come up taking nothing personal.

Management:

The management was like any other management, learning, working hard, making mistakes, getting experience, and working towards perfection.  I had worked with lots of managers at Matrix, so had lots of opportunities to learn from each of them.  Sometimes, you could run into a power struggle here or there, but nothing too serious, lots of good memories, good times, and good experience with the management team at Matrix.

Co-Workers:

Had no problems with any of my co-workers worth talking about in a negative way.  I had lots of friends, lots of good times and memories with my co-workers and we all learned from every experience, weather there was a conflict with each other or conversing about the Disability, Workers Comp or FMLA claim in front of us.  No complaints, nothing unusual, nothing abnormal.

The hardest part of the job:

Writing a denial letter was the hardest part for me to master, However, I have since mastered them.  We are required to write a business professional denial letter, explaining in specific detail as to why their Short Term or Long Term Disability claim was being denied, if the denial was due to "no objective medical evidence to support".  I cannot comment on FMLA and Workers comp, because I was not in charge of sending the letters for those pieces, but for me, the Short Term and Long Term Disability denial letters were the biggest challenge, but with practice, experience and after you have done enough of them, you tend to get good at them.  Additionally, another hard part of the job, was the high claim counts, sometimes it was hard to keep up.

The most enjoyable part of the job:

The fun times, good memories, friends made and professional work experience received.

The training was via a webinar where the trainers read power points to you which is not very effective. There was a some interaction with the trainees but not much. We were supposed to get assigned mentors for part of the day during training to go over the claims process, programs we are using etc. onsite, but since our office is so small Matrix does not provide any mentors unlike other sites in Phoenix and Portand. Our supervisor worked with us as much as she could but it was hard for her to take time so show us all the processes along with her additional duties. There is a high turn over in the office because of the impossible workload and high expectations put on the claims examiners. The veteran claims examiners work 10 to 12 hour days. We are salaried employees so no overtime. There is no way to complete all your tasks in an 8 hour period. Examiners that have worked there for over 10 years can't do it so they just work the extra hours with no overtime and just accept it. They are always stressed out. Coverage when staff take PTO or are sick is a huge problem. Your current workload is already enormous but when people are out you have to cover their tasks also. Makes it impossible to meet deadlines and complete daily tasks. Depending on the client you are assigned to in Matrix, you may have additional expectations and quotas to meet on top of what Matrix demands. The Austin office is assigned a high profile client that pays Matrix extra to meet their expectations. Because of this client, it makes our workload even more impossible to complete in an 8 hour day hence while all the veteran examiners are there daily for 10 hours or more. We are told to care for our claimants but we barely have enough time to objectively look over their claim to make a decision much less build a relationship of caring and trust with them. I would not recommend working for Matrix. The programs we use to manage the claims are old and ineffective. Because we have to use multiple programs, it makes managing the claim take longer and more mistakes happen because you have to constantly update both systems. Matrix keeps saying they are working on having one program that will manage both FMLA and STML but won't give a date to when it will be implemented. There are many unnecessary steps we have to take to document any change or update to a claim that take up too much time. When you have 80 to 100 tasks to complete in one day, these unnecessary steps eat up your day. The workflow process needs to be updated and shortened.

I worked here for nearly a decade. The job is very monotonous for the most part so once you get the hang of how to process a claim, they're all very similar. You'll be salaried unless you're in the call center. Which sounds great, but you'll have to work long hours to keep on top of your caseload. The turnover is insane because most people can't or won't put up with the job for long. This creates a workplace of mostly new employees who don't know what their doing... Making things worse and perpetuating the cycle. By the time I left, I was so overwhelmed that I was putting in 12 hour days, 7 days a week. They tell you to "just clock out" at the end of your normal day. But in doing so you end up falling behind and it becomes a performance issue. If you have any empathy for the clients, you don't want to let them down as they're relying on you to process their claims timely. Otherwise they are off work and have no income. It creates a culture of only seeing the clients as numbers. If you get emotionally involved at all, its soul crushing. I'm an empath, and I wasn't happy with what I was doing. Saying "oh well... I don't have time, so you'll have to wait another week to get paid." Just felt wrong. But that's how you have to work to stay sane. If you call out or take vacation time, your team is already overwhelmed and can't cover your work so you come back to a nightmare, almost feeling punished for taking time off at all. I loved my manager and supervisor. They were like family. But that's not the case on all teams. I had 580 claims to manage which was almost three times the industry average. I was making around 60k, but had to put in so many hours that I effectively made less than minimum wage. The work isnt hard. But you won't find much time for yourself. Personally, between things I was being asked to do by management that I didn't agree with, ways clients were being treated by Matrix and their employers, the fact that everyday I'd get yelled at by someone who hadn't been paid yet because I simply hadn't been able to process their claims on time (by company best practices and legal standards) because I had too much on my plate... I found it impossible to "turn it off" at home. I became isolated and severely depressed. Eventually I had to quit for my own mental health and personal well-being. 

•	Administer Family & Medical Leave Act (FMLA) standalone claims related to childcare, family member illness/injury or employee illness/injury. 
•	Responsible for all day-to-day aspects of administration of all employee leave requests, including tracking and claims processing. 
•	Develop a working rapport with management to promote a positive working environment. 
•	Monitor employee progress during leave and ensure that all policies are followed. 
•	Effectively work with department heads, managers, and supervisors of employees on leave and ensure a successful return to work, including the timely addressing of conduct issues throughout the duration of the leave. 
•	Effectively interface with current clients to ensure that employees are taken care of in a professional and timely manner. 
•	Understand,  stay current, and adhered to federal and state regulatory and/or company plan requirements
•	Investigate, evaluate and determine benefit eligibility of Short Term Disability claims in a timely fashion.
•	Determine eligibility under federal, state and client specific requirements for leaves submitted
•	Medical certification review and management supplied by the healthcare provider.
•	Determine the duration associated with the leave based on the information given by the healthcare provider.
•	Effectively work with department heads, managers, and supervisors of employees on leave and ensure a successful return to work, including timely addressing of issues throughout the duration of the leave. 
•	Manage leaves that are concurrent with Client Specific leaves and Workers’ Compensation.
•	Act as an advocate for employees and ensure correct compensations while they are out on leave

Delivered accurate, timely and appropriate delivery of leave of absence benefits and policies specific to pregnancy disability leave, Military leave, Personal leave and Family medical Leave Act and California Family Right Act.  Administers both consecutive and intermittent leaves from commencement through return to work or termination.  received and managed leaves assigmets as assigned.  Processed and managed all assigned request for LOA coordinating, interpreting and applying leave policies,  sending letters of leave status and communication, reviewing supporting documentation and certification, calculating monitoring leave duration in conjunction with policy and/or state and federal law, authorizing or denying all LOA request and coordination return to work for PDL and reduced work schedules applicable to qualifying FMLA/CFR leaves.  Tracks and monitors all aspects of their assigned case load to assure compliance with governmental and facility-specific policies and for the case management documentation in the information system. Interpreted and classified and LOA policy guidelines to employees, supervisory and manager's to ensure accurate, fair and consistent application of policy provisions and escalates case management issues or concerns to the assigned management resources as appropriate.

I think I worked with the previous employee review that included all the reasons to provide you with the reasons to avoid this unhealthy enviroment in the Matrix company and specifically the Austin location.   There is a high turn over in the office because of the impossible workload and high expectations put on the claims examiners. There is no way to complete all your tasks in an 8 hour period. Everyone is always stressed out. Coverage when staff takes PTO or are sick is a huge problem. Your current workload is already enormous but when people are out you have to cover their tasks also. Makes it impossible to meet deadlines and complete daily tasks. I would not recommend working for Matrix. The programs to manage the claims are old and ineffective. Because we have to use multiple programs,you have to constantly update in both systems. 

If you are looking for a meaningful, stable and advancing career, I advise you to keep looking. Good luck in your search and I hope you find an employee that will appreciate your attributes and provide learning, growth and happiness. You deserve it!

A typical work day consists of working out of a leave of absence system and also a short term disability system. Both systems houses 'tasks" that will need to be completed by the end of the business day. typically there are about 40-50 tasks that need to be completed in total in both systems. Claims examiner will also need to  review emails which have to be responded same day if the came in before 3pm and also check voicemail and return phone calls from previous day and any calls made present day before 3pm. I work on a team of about 12 other examiners but we all have different case loads. I have 2 assistants and I have 2 clients that I manage. The hardest part of m job is phone calls. I get about 20-25 phone calls a day and having to manage my work load and emails make answering the phone difficult and returning calls difficult at times. Also most of our work load requires a work day of 10+hrs. Most enjoyable part of my job is not being micromanaged. Our manage trusts us enough to know that we will do everything in our power to get the job done. We are one of the hardest working teams in our company.

Workload is ridiculous, pay is not competitive, no chance for advancement regardless your qualifications unless you know someone or are related to the right people.

If they want to bring in a relative or a friend they will let an existing employee go to make room for their family member or friend. 

Management is sneaky and will lie straight to your face. They cover things up in order to make themselves look good and you cannot trust anyone in that company. 

If this is the type of environment you would like to work in feel free to apply, if not keep looking. Having Matrix on your resume will actually make your job search harder if you are looking to leave. 

My advice keep looking and don't even waste your time applying. They merely offer a temporary job and a pay check, not a long term career Employees are not valued and the high turnover reflects this. 

The company also participates in outsourcing to the Philippines and will let existing American citizens go. If job security is your concern, this is definitely not the place for you.

Great sense of gratification knowing that you are providing a great service to others in a time of need.

Upon interviewing, information is given to indicate that average work load is 80-100 integrated claims when in all actuality, typical work load averages from 200-300, integrated as well as stand-alone claims.

Management severely lacks focus and direction as well as motivation to teams.  No follow-up or follow through is provided on a consistent basis.  No one teams functions or operates in the same manner as any other team on the floor.

There really isn't much room or opportunity for growth within the company.  No real additional training or shadowing provided for those that want to learn a different skill set.  

The hardest part of the job is being consistent across the board on the processes and procedures for working claims.  Taught one thing in training only be told to do entirely different steps once on the "floor".

As an examiner, micromanaged, constant turnover, toxic environment, soul crushing work. Wasted a decade of my life. Things were great the first 5 years or so. Then we got a new CEO who is burning this company into the ground. Workloads are obscene and unmanageable. Recently got pushed from salary to hourly and no overtime is approved. We were already working 10+ hours a day because you would have on average 50+ tasks per day, 30+ phone calls and emails from claimants and clients. Metrics are a dumpster fire and management doesn't show any care. One unit has their stuff together and the other doesn't. They don't take your feedback seriously and it's so frustrating. Go to HR many times, NOTHING changes. All tenured folks are being pushed out the door and they don't care. Examiners and supervisors are dropping like flies because it's just too much. They truly don't care, that's very evident. This place is toxic and will ruin you. 

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