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Dexian · 14 hours ago

Disability Claims Specialist (Part Time)

United States

Part-time

Remote

Mid Level

$40/hr - $47/hr

3+ years exp

Dexian is a leading provider of staffing, IT, and workforce solutions. They are seeking a Disability Claims Specialist to evaluate Long-Term Disability insurance claims while delivering excellent customer service and managing a caseload of claims in compliance with regulations.

ConsultingHuman ResourcesInformation TechnologyProfessional ServicesStaffing Agency

Responsibilities

Manage an assigned caseload of moderately complex LTD claims (pending, active, and appeals) with some oversight

Deliver timely, accurate, and balanced claim decisions in compliance with state and Department of Insurance regulations

Conduct proactive, empathetic phone communication with claimants and representatives to:

Gather medical, occupational, financial, and treatment details

Explain claim status, benefits, and plan provisions

Document all interactions clearly and professionally in the claim system

Communicate effectively with claimants, attorneys, brokers, customers, and family members

Analyze claim file documentation and determine when additional information is needed

Collaborate with internal and external partners (physicians, attorneys, clinical/vocational consultants)

Identify inconsistencies and coordinate with Fraud, Waste, and Abuse resources as needed

Calculate monthly benefits including:

Elimination period payouts

COLA

Social Security offsets

Rehab / Return-to-Work benefits

Provide detailed written updates throughout the claim lifecycle

Resolve escalated customer complaints and route matters to appeals, complaints, or litigation support teams when appropriate

Qualification

LTD insurance claims experienceAnalytical skillsCritical thinkingCustomer service experienceOrganizational skillsConceptual thinkingRisk managementVerbal communicationWritten communicationTime managementProblem-solving skillsDecision-making