Disability Claims Examiner
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Job Location:
Monthly Salary:
Posted on:
3 days ago
Vacancies:
1 Vacancy
Job Summary
The Disability Claims Examiner is in charge of reviewing deciding and handling disability claims in line with policy rules regulatory requirements and organizational standards. This job makes sure that claims are handled correctly on time and in accordance with the law while also providing professional and caring service to claimants employers and medical providers. The Disability Claims Examiner is very important for keeping risk management regulatory compliance and customer experience in balance.
Main Duties:
Look over study and decide on claims for short-term and/or long-term disability
Use the policy language medical records and job information to figure out who is eligible and what benefits they can get.
Ask for look over and make sense of medical records employer statements and other supporting documents.
Tell claimants and stakeholders about claim decisions in a clear and professional way.
Keep claims management systems up to date and correct with their records.
Make sure you follow all federal and state laws that apply including ERISA when it applies.
Work with doctors career counselors and departments within the company
Keep track of claim inventories to make sure they meet service level and productivity standards.
Find possible fraud chances to get money back or times when a claim needs to be raised.
Take part in ongoing training audits and reviews of quality assurance
Necessary Qualifications:
A bachelors degree in business administration healthcare administration human resources or a related field (or equivalent work experience)
At least 3 to 5 years of experience managing disability claims insurance claims or benefits
A lot of knowledge about disability insurance policies and how to handle claims
The ability to look at medical and job-related information
Great skills in both writing and speaking
Good at organizing and paying attention to details
Ability to work alone in a place that is far away
Knowledge of Microsoft Office Suite and claims management systems
Preferred Qualifications:
Experience with disability plans that are governed by ERISA
Professional certifications like CEBS LOMA or certifications for filing disability claims
Experience handling claims for short-term and long-term disability
Knowing the rules about disabilities at the state and federal levels
Pay for the Year:
Salary Range: $65000 to $95000 a year depending on where you live how much experience you have and what certifications you have.
Benefits Package:
Full coverage for medical dental and vision care
401(k) retirement plan with a match from the company
Paid time off (PTO) includes vacation days sick days and paid holidays.
A fully remote work arrangement in the US
Ongoing support for professional development and certification
Insurance for life and short- and long-term disabilities
Programs for employee health and well-being
Key Skills
- Auditing
- GAAP
- Military Experience
- Phlebotomy
- Conflict Management
- Vital Signs Experience
- Computer Forensics
- Research Experience
- Securities Law
- Operating Systems
- PTSD Care
- RMF
