Disability Claims – Underwriting Specialist

This is a fully remote position, open to applicants in United States, +2 more countries.

📋 Description

• Develop realistic scenarios related to short- and long-term disability claims, including elimination periods, definitions for own-occupation and any-occupation, as well as residual and partial disability, offsets, recurrent disability, and management of claim duration.

• Generate claim determinations, benefit calculations, summaries of medical and vocational evidence, transferable-skills analyses, return-to-work plans, and decisions on appeals.

• Compose “golden” reference responses that meet the high standards of experienced disability professionals.

• Evaluate AI-generated responses against structured rubrics to ensure definitional accuracy, evidentiary support, correctness in benefit calculations, and procedural fairness.

• Detect misapplied disability definitions, unsupported functional conclusions, overlooked offsets, erroneous benefit calculations, and deficiencies in documenting the administrative record.

• Offer written feedback to the research team aimed at enhancing model performance.

• Engage in onboarding office hours and calibration sessions.

⛳️ Requirements

• Over 2 years of professional experience in adjudicating disability claims, disability underwriting, vocational rehabilitation, or leave and absence management.

• Familiarity with at least one type of program: group short-term disability, group long-term disability, individual disability income, statutory disability, or life waiver of premium.

• Knowledge of contract definitions, elimination periods, offsets, provisions for pre-existing conditions, and maximum benefit durations.

• Capacity to assess medical, occupational, and financial evidence and articulate a defensible determination with well-documented rationale.

• Strong written analytical skills, balanced judgment, and exceptional attention to detail.

• Ability to differentiate between claim adjudication and clinical decisions made by treating providers, as well as formal legal advice.

• Bonus: CRC, CDMS, CCM, CPDM, RN, or a similar clinical or vocational credential.

• Experience with ERISA administrative records, appeals, or support in litigation.

• Knowledge of individual disability income underwriting, including occupational class and financial underwriting.

• Experience in coordinating offsets with Social Security, workers compensation, or other income sources.

• Familiarity with FMLA, state leave programs, or interactions related to ADA accommodations.

• Eligibility for remote work is limited to candidates residing in the United States, Canada, or the United Kingdom.

🏝️ Benefits

• $800 per task.

• Minimum of 20 hours per week (ideally 40+ hours).

• Flexible remote working arrangements.

• Up to $250 for each successful referral.

• Reasonable accommodations available upon request.