Disability Claims Examiner jobs in the United States
Disability Claims Examiner reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner typically reports to a supervisor/manager. To be a Disability Claims Examiner typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)
Recently Added Disability Claims Examiner jobs
Long Term Disability Claims Examiner
- Reliance Matrix
-
South Portland, ME
FULL_TIME
-
Job Responsibilities And Requirements
The Claim Examiner II obtains and analyzes information to make claim decisions and payments on Long Term Disability “LTD” and Waiver of Premium “WOP” claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy.
To learn more about the Claim Examiner II position, watch our exclusive employee video!
Duties and Responsibilities:- Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim.
- Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line.
- Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner.
- Conducts in-depth pre-existing condition or contestable investigations if applicable.
- Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, cost of living adjustments, etc.
- Develops and maintains on-line claim data (and paper file if applicable).
- Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.
- Fully investigates and adjudicates a large volume simple to complex claims.
- Identifies and investigates change in Total Disability definition (any occ).
- Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit.
- Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium.
- Majority of work is not subject to supervisor review and approval.
- Independently manages assigned case load as outlined in LTD Key Measures
- Collaborates with team members and management in identifying and implementing improvement opportunities.
- Remains current with all corporate and disability management practices.
- Collaborates with team members and management in identifying and implementing improvement opportunities.
- Collaborates with management on claims with high degree of complexity.
- Any other job-related duty as deemed appropriate by management.
- or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*
- High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred.
- 2 years experience processing long term disability claims.
- Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation.
- Experience working in confidential/protected identification environments.
- Knowledge of medical terminology.
- Good math and calculation skills.
- Proven ability to work well in a high-visibility, public-oriented environment.
- Customer Service: Promptly acknowledges customers' needs, both internal and external. Ensures customers' needs are handled in a timely and appropriate manner. Creates a positive impression.
- Communication/Relationship Skills: Demonstrates effective interpersonal and listening skills: takes direction, practices active listening, accepts feedback. Communicate/respond appropriately to varied audiences/tasks. Exhibits teamwork, honors commitments.
- Problem Solving/Decision Making: Anticipates, analyzes and defines problems. Develops and assesses alternative solutions as necessary. Makes appropriate decisions in a timely manner. Analyzes impact of decisions.
- Productivity: Work is accomplished quickly and accurately. Takes responsibility for actions. Prioritizes work effectively and uses time efficiently. Accomplishes goals and objectives.
- Dependability: Makes/fulfills commitments. Consistently works independently, meets deadlines, and accepts responsibility for his/her actions. Adheres to all attendance requirements. Prompt, well prepared and ready to contribute.
Work location may be flexible if approved by the Company.
What We Offer
At Reliance Matrix, we believe that creating a more diverse, equitable and inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you.
That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.
Our Benefits:- An annual performance bonus for all team members
- Generous 401(k) company match that is immediately vested
- A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
- Multiple options for dental and vision coverage
- Company provided Life & Disability Insurance to ensure financial protection when you need it most
- Family friendly benefits including Paid Parental Leave & Adoption Assistance
- Hybrid work arrangements for eligible roles
- Tuition Reimbursement and Continuing Professional Education
- Paid Time Off, volunteer days, community partnerships, and Employee Assistance Program
- Ability to connect with colleagues around the country through our Employee Resource Group program and our Diversity Equity & Inclusion Council
- Integrity
- Empowerment
- Compassion
- Collaboration
- Fun
Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.
- 6 Days Ago
Claims Examiner
- AIG Claims, Inc.
-
Remote, OH
FULL_TIME
- Who we are American International Group, Inc. (AIG) is a leading global insurance organization. AIG member companies provide a wide range of property casualty insurance in approximately 70 countries a...
- 16 Days Ago
Disability Claims Examiner I - Salt Lake City
- State of Utah
-
Salt Lake, UT
FULL_TIME
- The Department of Workforce Services (DWS) is seeking a motivated and highly skilled Disability Claims Examiner I to join the Disability Determination Services (DDS) team in our Salt Lake City office....
- 2 Months Ago
Claims Examiner
- Sedgwick Claims Management Services Inc.
-
Marlton, NJ
OTHER
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flex...
- 11 Days Ago
1099 CAT Claims Examiner
- Hancock Claims Consultants
-
Alpharetta, GA
CONTRACTOR
- At Hancock Claims Consultants, we are at the forefront of claims resolution services, offering nationwide coverage, swift and comprehensive claims inspections, and unparalleled quality and precision. ...
- 3 Days Ago
1099 CAT Claims Examiner
- Hancock Claims Consultants
-
Tampa, FL
CONTRACTOR
- At Hancock Claims Consultants, we are at the forefront of claims resolution services, offering nationwide coverage, swift and comprehensive claims inspections, and unparalleled quality and precision. ...
- 3 Days Ago
Disability Claims Examiner jobs at Popular Companies
Aviation Safety Assistant (Office Automation), Columbus FSDO, GLSD03
- US Department of Transportation
-
Columbus, OH
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Workers' Compensation Attorney - Remote
- Orion Placement
-
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- Preferred Mutual Insurance Company
-
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Mechanic III (Nights)
- The Judge Group
-
New Albany, OH
- HELP US BRING THE GIFT OF HEALTH TO LIFE.Working at Pharmavite is an experience like no other. With a focus on complete ...
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Claims Examiner - Liability
- Sedgwick
-
Columbus, OH
- **The 'Apply with SEEK' option will be utilized for International applicants, mainly Australia. If this does not apply t...
- 6/9/2024 12:00:00 AM
Intermittent Accountant/Examiner 2 (P.N. 20080730, 20076383)
- State of Ohio
-
Columbus, OH
- This is a Temporary Assignment. Who Are We? The Department of Developmental Disabilities (DODD) is a trauma informed car...
- 6/9/2024 12:00:00 AM
Document Specialist
- IME RESOURCES LLC
-
Dublin, OH
- Document Specialist Requisition ID 2024-10427 of Openings 1 Category Operations Location US-OH-Dublin Overview Are you s...
- 6/8/2024 12:00:00 AM
Mechanic II (Days)
- Hiring Now!
-
New Albany, OH
- HELP US BRING THE GIFT OF HEALTH TO LIFE.Working at Pharmavite is an experience like no other. With a focus on complete ...
- 6/8/2024 12:00:00 AM
Income Estimation for Disability Claims Examiner jobs
$50,245 to $62,381