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    Disability Claims Specialist - Hometown, United States - Metasys Technologies

    Metasys Technologies
    Metasys Technologies Hometown, United States

    1 week ago

    Metasys Technologies background
    Description
    Disability Claims Specialist
    Remote Position
    12+ Month Contract

    Client is seeking a highly skilled Disability Claims Specialist to join the team immediately. This role offers the flexibility of remote work and requires a commitment of 10-20 hours per week. As a Disability Claims Specialist, you will play a crucial role in evaluating long-term disability insurance claims, ensuring compliance with plan provisions and regulatory standards, and providing exceptional customer service.

    Responsibilities:
    • Manage an assigned caseload of moderately complex claims, including pending, ongoing/active, and appeal reviews.
    • Conduct thorough and timely reviews of claims documentation, ensuring accuracy and adherence to regulatory requirements.
    • Communicate effectively with claimants, attorneys, brokers, and other stakeholders, demonstrating empathy, active listening, and clear articulation of information.
    • Collaborate with internal and external resources, such as physicians and vocational consultants, to gather necessary data for claim evaluation.
    • Calculate monthly benefits accurately, considering factors such as COLA, Social Security Offsets, and Rehabilitation Return to Work benefits.
    • Document all interactions and decisions in claim files with professionalism and attention to detail.
    • Address and resolve escalated customer complaints in a timely and thorough manner, identifying and referring matters to appropriate support areas when necessary.
    Requirements:
    • 3+ years of prior LTD/IDI Insurance Claims experience.
    • Strong analytical skills and ability to exercise independent judgment.
    • Demonstrated proficiency in critical thinking, problem-solving, and decision-making.
    • Excellent interpersonal and communication skills, both verbal and written.
    • Bachelor's degree in a relevant field.
    • Organizational and time management skills, with the ability to prioritize tasks effectively.
    • Familiarity with state and department of insurance regulations preferred.
    Metasys Technologies is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
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