Disability Claims Specialist - REMOTE
<p><strong>Job Title:</strong> Disability Claims Specialist (Part-Time)</p><p> <strong>Location:</strong> Fully Remote</p><p> <strong>Employment Type:</strong> Part-Time (20 Hours per Week)</p><p> <strong>Schedule:</strong> Monday – Friday, between <strong>7:00 AM – 5:00 PM (Local Time)</strong></p><p> </p><p><strong>Note:</strong> Candidates who receive an offer will be required to successfully complete a <strong>background check and drug test</strong> as a condition of employment.</p><p><br></p><p>Position Overview</p><p>We are seeking an experienced <strong>Disability Claims Specialist</strong> to evaluate <strong>Long-Term Disability (LTD) and Individual Disability Insurance (IDI) claims</strong> in accordance with policy provisions and established service standards.</p><p>This role requires strong <strong>analytical ability, sound judgment, and excellent customer service skills</strong> while managing a caseload in a fast-paced, remote environment. The specialist will interact directly with claimants, medical professionals, attorneys, and internal stakeholders to ensure fair, accurate, and timely claims determinations.</p><p>This is a <strong>part-time remote opportunity requiring approximately 20 hours per week</strong>, with availability during standard business hours.</p><p><br></p><p>Key Responsibilities</p><ul><li>Manage an assigned caseload of <strong>moderately complex disability claims</strong>, including pending, ongoing, and appeal reviews.</li><li>Evaluate claims based on <strong>policy provisions, medical information, occupational data, and regulatory requirements</strong>.</li><li>Conduct frequent <strong>telephone outreach to claimants or their representatives</strong> to gather necessary information regarding medical conditions, treatment, and occupational details.</li><li>Document all communications and claim activity accurately and promptly within the claims system.</li><li>Provide <strong>clear, professional written and verbal communication</strong> regarding claim status, decisions, and next steps.</li><li>Collaborate with internal and external partners including <strong>physicians, attorneys, clinical consultants, and vocational specialists</strong> to gather information required for claim evaluations.</li><li>Identify and resolve discrepancies in claim information and escalate concerns when necessary, including potential fraud or abuse cases.</li><li>Calculate monthly disability benefits including <strong>COLA adjustments, Social Security offsets, and return-to-work benefits</strong>.</li><li>Address escalated customer concerns and direct complex matters to appeals or litigation support teams when appropriate.</li><li>Maintain compliance with <strong>state regulations and Department of Insurance requirements</strong>.</li></ul><p><br></p><p>Required Qualifications</p><ul><li><strong>Minimum 3+ years of experience handling LTD or IDI insurance claims</strong></li><li>Bachelor’s degree</li><li>Ability to exercise <strong>independent judgment and decision-making</strong></li><li>Strong <strong>critical thinking and analytical skills</strong></li><li>Proven <strong>problem-solving abilities and attention to detail</strong></li><li>Excellent <strong>written and verbal communication skills</strong></li><li>Demonstrated <strong>customer service experience</strong></li><li>Strong <strong>organizational and time management skills</strong></li><li>Ability to manage multiple priorities in a fast-paced environment</li></ul><p>Work Schedule</p><ul><li><strong>Part-Time:</strong> Approximately <strong>20 hours per week</strong></li><li>Must be available during <strong>core business hours (Monday – Friday, 7:00 AM – 5:00 PM local time)</strong></li><li>This role <strong>does not support evening or weekend schedules</strong></li></ul><p></p>