Disability Benefit Specialist

Disability Benefit Specialist - Remote.

Make an impact from anywhere!

Join us as a Disability Benefit Specialist and play a key role in evaluating claims, determining benefit eligibility, and guiding employees toward successful return-to-work strategies.

Use your expertise in disability policies and medical/vocational issues to deliver clear, timely decisions and exceptional support-all from the comfort of your home.


* Bachelor's degree or equivalent experience required.


* 2 + years of STD/LTD claims adjudication


* Experienced in the TPA or self-administration services is desired


* Experience with FMLA/State leave claims is a plus


* Aptitude for learning medical terminology and conditions, as well as interpreting procedures and regulations


* Ability to work independently while assimilating various technical resources


* Computer knowledge in excel, word, web based systems, etc


* Good verbal and written communication skills


* Knowledge of ERISA regulations, required offsets and deductions, disability duration and Social Security procedures


* Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.


* Strong ability to identify, analyze and solve problems.


* Effective interpersonal skills capable of dealing with external sources and all levels of employees.

#LI-DV1


* Manages assigned caseload of disability claims for Short Term/Long Term Disability.


* Communicates with claimants, employers, and various medical professionals to gather information regarding eligibility, benefit authorization, and ongoing management of STD or LTD benefits.


* Applies the appropriate contractual provisions; case management resources; and claim processes to ensure eligibility requirements and liability decisions are accurate.


* Provides superior customer service by rendering benefit determinations within expected timeframes and quickly responding to all inquiries.


* Demonstrates ability to independently manage disability claim and apply clinical guidance as provided on more complex claims.


* Verifies on-going disability and participates in claim reviews with specialized resources including nurses, physicians, vocational rehabilitation, etc.

to discuss return to work opportunities as appropriate.


* Uses disability claim system to manage and authorize payment on claims while meeting all service, timeframe, and productions standards


* Ensures a timely and appropriately coordinated transition of claims from STD to LTD, providing a well -managed and seamless claims experience to claimants.


* Analyzes claims activity and prepares reports for clients/carriers and management as needed


* Becomes familiar with specialized client instructions and performance guarantee standards for any assigned clients.

Serves as a resource for trainees and Claims processors as needed.


* Effectively works toge...