Disability Claims QA Specialist

Jobgether; United States; Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Competitive compensation

Medical, dental, vision insurance

401(k) retirement plan

Remote work stipend

Apple equipment provided

Performance bonuses

Professional development opportunities

Job summary

Jobgether, on behalf of a partner company, seeks a Disability Claims QA Specialist based in the United States. You will ensure accuracy of medical reports supporting long-term disability claims, review physician reports, and verify evidence substantiates determinations.

Work with clients and physician reviewers to maintain high accuracy under deadlines. This remote role targets detail-oriented professionals with claims experience and a background in healthcare or insurance, ready to contribute

Qualifications

• Previous disability claims experience is required.
• An Associate’s or Bachelor’s degree is preferred.
• Ability to interpret policy guidelines and healthcare terminology.
• Strong attention to detail and accuracy in documentation.

Responsibilities

• Review physician reports and medical records for long-term disability claims.
• Verify that documentation substantiates physicians’ determinations.
• Interpret policy guidelines and healthcare terms to assess criteria.
• Communicate with clients and reviewers to address outstanding questions.
• Oversee complex long-term disability cases requiring quality review.
• Ensure deliverables meet client deadlines with high quality.

Skills

Disability claims experience

Attention to detail

Communication skills

Time management

Education

Associate’s degree

Bachelor’s degree

Tools

Google Chrome

Gmail

Google Docs

Google Sheets

Job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Disability Claims QA Specialist based in the United States.

The Disability Claims QA Specialist will play a key role in ensuring the accuracy, completeness, and quality of medical reports supporting short-term and long-term disability claims. This role combines disability claims expertise, clinical documentation review, and quality assurance to help deliver reliable outcomes for clients. You will assess physician reports, verify that medical evidence supports clinical determinations, and ensure all relevant questions are addressed before cases are returned. Working closely with physician reviewers, their teams, and clients, you will help maintain high standards of accuracy while meeting strict service deadlines. You will also provide additional oversight for complex cases and identify issues requiring further review. This remote opportunity is suited to a detail-oriented professional who thrives in a fast-paced healthcare and insurance environment.

Accountabilities

• Review physician reports and accompanying medical records to ensure they meet client expectations and relevant standards for long-term disability claims.
• Verify that the medical documentation and supporting evidence appropriately substantiate physicians’ determinations.
• Interpret disability policy guidelines and healthcare terminology to assess whether the applicable criteria for long-term disability are met.
• Work directly with clients on individual cases, providing responsive service and delivering complete, accurate, and timely quality assurance.
• Communicate with physician reviewers and their teams to clarify information, address outstanding questions, and ensure reports respond to all requested points.
• Manage and oversee complex long-term disability cases that require additional quality review before being returned to clients.
• Provide an additional layer of quality assurance for cases presenting documentation or quality concerns, applying specialized disability claims knowledge.
• Ensure all deliverables meet client deadlines while maintaining consistent accuracy and quality standards.
• Participate in additional assignments and special projects as required by business needs.

Requirements

• Previous disability claims experience is required.
• At least 5 years of claims experience is preferred.
• Experience in healthcare, insurance, or a related business environment is an advantage.
• An Associate’s or Bachelor’s degree is preferred.
• Ability to interpret policy guidelines, understand healthcare terminology, and assess medical documentation in the context of disability claims.
• Strong attention to detail and a consistent commitment to accuracy and completeness.
• Excellent written and verbal communication skills, with the ability to communicate clearly and professionally with clients and physician reviewers.
• Strong critical-thinking and problem-solving abilities, including the judgment to identify inconsistencies and determine when further review is necessary.
• Effective time-management and organizational skills, with the ability to work independently, prioritize tasks, and meet strict deadlines.
• A self-motivated and performance-driven approach, with a strong sense of urgency and accountability.
• Proficiency in using computers and navigating multiple software applications; familiarity with Google Chrome, Gmail, Docs, and Sheets is an advantage.
• Good typing skills and general computer literacy.
• Ability to work remotely while maintaining a reliable, uninterrupted internet connection. Employees are responsible for supplying and supporting their own internet service.

Working Conditions

• The role involves extended periods of sitting and working at a computer.
• Candidates should be able to meet the physical demands associated with the responsibilities of the position, including any required lifting, bending, or travel.

Benefits

• Competitive compensation based on experience, education, and relevant skills.
• Comprehensive medical, dental, and vision insurance for employees and their families.
• Voluntary life insurance options for employees, spouses, and children.
• Additional voluntary coverage options, including hospital indemnity, critical illness, accident indemnity, and pet insurance.
• Basic life insurance at no cost to employees.
• Short-term and long-term disability coverage at no cost to employees.
• Paid time off to support work-life balance and personal well-being.
• 401(k) retirement plan with company matching contributions.
• Apple equipment provided for the remote workspace.
• Media stipend to support remote work.
• Performance bonuses.
• Opportunities for professional development and career growth within a performance-oriented organization.

How Jobgether Works

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.