This role focuses on the evaluation and management of individual disability insurance (IDI) claims. The specialist is responsible for reviewing medical documentation, financial records, and occupational details to assess claim validity and determine eligibility for benefits. Each case is analyzed thoroughly to ensure decisions align with policy terms, legal requirements, and customer circumstances.
Key Responsibilities
- Collect and assess medical, financial, and employment information to determine disability claim eligibility
- Review insurance applications for accuracy and coordinate with underwriting and legal teams when necessary
- Collaborate with medical consultants, vocational specialists, and financial analysts to support comprehensive evaluations
- Make informed decisions on claim approvals and ensure accurate benefit payments are issued
- Identify potential fraud or litigation risks and maintain well-documented, defensible case files
- Prioritize high-impact tasks and drive case resolution efficiently
Qualifications
Applicants must have 3–5 years of experience in disability claims, including at least two years focused on IDI. Strong analytical abilities and familiarity with interpreting medical records, financial statements, and policy language are essential. Experience working with underwriting, reinsurance providers, and investigative resources is required. A bachelor’s degree is preferred, though extensive IDI claims experience may substitute.
Work Environment & Benefits
This position supports a flexible work model and offers a comprehensive benefits package, including medical, dental, and vision coverage, a 401(k) with company match, and an annual incentive plan. Employees receive generous paid time off, including holidays, wellness days, and volunteer hours. Additional benefits include paid parental leave, adoption and surrogacy support, and an employee donation matching program. Career development and internal advancement are encouraged, supported by a management team committed to employee growth.
Company Culture
The organization values initiative, customer-centered service, and continuous improvement. Employees are expected to take ownership of their work, understand customer needs, and seek ways to enhance processes and outcomes. A commitment to fairness, inclusion, and ethical practices is central to daily operations.
