Disability Claims Examiner – LTD

This is a fully remote position, open to applicants in California, +3 more states.

📋 Description

• Oversee a designated portfolio of around 95 to 100 Long-Term Disability claims.

• Deliver outstanding customer service while meeting commitments and deliverables.

• Engage in communication via phone, email, and text with employees, employers, attorneys, and other stakeholders.

• Analyze and interpret medical records, utilizing relevant resources as necessary.

• Perform financial computations.

• Apply knowledge of claim systems, policies, procedures, contracts, and regulatory and statutory requirements.

• Accurately determine eligibility and liability by applying contract and policy provisions.

• Collaborate with medical and vocational resources to assess disability and promote return-to-work objectives.

• Confirm ongoing liability and devise return-to-work strategies.

• Document clear, objective, and technical rationales for claim decisions.

• Convey claim decisions both verbally and in written form.

• Utilize available resources, materials, and tools to make claims decisions.

• Ensure claims are paid accurately and promptly, respond to inquiries, and uphold service and quality standards.

• Manage multiple priorities and stringent deadlines in a dynamic environment.

• Operate independently while also being an effective collaborator within a team setting.

⛳️ Requirements

• At least 2 years of experience in Long Term Disability Claim Management or a closely related field.

• Exceptional skills in customer service.

• Proven track record of positively and effectively engaging with challenging customers.

• Strong written and verbal communication abilities.

• Bilingual communication skills in Spanish and English are preferred.

• Excellent organizational and time management capabilities.

• Ability to multitask, prioritize tasks, and adapt to shifting priorities.

• Detail-oriented, with strong analytical skills for contract information research.

• A demonstrated sense of urgency.

• Experience in achieving or surpassing individual performance expectations and team objectives.

• Strong analytical and mathematical skills.

• Ability to apply critical thinking, risk management, and sound judgment.

• Capacity to adapt, resolve issues quickly, and communicate effective solutions.

• Flexibility to meet changing organizational requirements.

• Self-motivated and independent, while also being able to work efficiently in a team.

• A commitment to continuous improvement.

• Dedication to fostering a diverse and inclusive workplace.

• Strong computer skills and the ability to navigate multiple systems.

• Proficiency in PC-based applications such as Excel and Word.

🏝️ Benefits

• Competitive base salaries that align with market standards.

• Opportunity for yearly bonuses at all levels.

• Comprehensive medical, dental, vision, life, and disability insurance.

• Paid Time Off (PTO).

• Leave benefits for parental and military service.

• 401(k) plan with company matching up to 4%.

• Company-sponsored pension plan.

• Wellness Programs offering up to $1,600 annually for personal wellbeing reimbursements.

• Work/Life Resources that assist with parenting, housing, senior care, finances, pets, legal issues, education, emotional health, and career development.

• Educational benefits for approved degree and accredited certificate programs.

• Employee Stock Purchase Plan allowing shares to be acquired at 85% of the lower of two prices.

• Eligibility for discretionary annual incentive programs.

• An inclusive workplace with opportunities for career development.