IDI Claims Specialist

Hays; United States; Remote; USD 60,000 - 80,000; Part time

Job summary

A leading company is seeking a Part-Time Individual Disability Insurance Claims Specialist to manage and evaluate claims based on individual disability insurance policies. The role involves critical judgment and customer interactions to ensure timely and accurate claims processing, coupled with excellent organizational and problem-solving skills. This remote position offers a competitive hourly wage and opportunities for professional growth within the insurance field.

Benefits

Medical benefits

Dental benefits

Vision benefits

401K

Life Insurance

Qualifications

• 3+ years of IDI or LTD insurance claims experience.
• Excellent verbal and written communication skills.
• Ability to manage complex situations effectively.

Responsibilities

• Independently manages claims caseload and evaluates individual disability claims.
• Provides detailed communications during claim evaluations.
• Collaborates with physicians and attorneys for claim evaluations.

Skills

Critical thinking

Problem-solving

Interpersonal skills

Customer service

Organizational skills

Job description

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This range is provided by Hays. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Part-Time Individual Disability Insurance Claims Specialist – Contract – Remote – $45-50/hr.

The final salary or hourly wage, as applicable, paid to each candidate/applicant for this position is ultimately dependent on a variety of factors, including, but not limited to, the candidate’s/applicant’s qualifications, skills, and level of experience as well as the geographical location of the position.

Applicants must be legally authorized to work in the United States. Sponsorship not available.

Our client is seeking a Part-Time Individual Disability Insurance Claims Specialist.

Responsibilities

The IDI Senior Claims Specialist evaluates individual disability income insurance claims and makes claims decisions in accordance with policy provisions and within prescribed time service standards. In this role, the IDI Senior Claims Specialist is responsible for exercising independent judgment, demonstrating critical thinking skills, exemplary customer service as well as effective inventory management skills.

Key Responsibilities:

• Independently manages an assigned caseload of, and makes claims decisions on, moderately complex claims which consists of pending, ongoing, disputed and appeal reviews.
• Provides timely, balanced, and accurate claims reviews, documentation, and decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations.
• Provides timely and detailed written communication throughout the claim evaluation outlining comprehensive claim status and/or claim determinations.
• Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during claim evaluations.
• Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members throughout the claim evaluation.
• Compiles file documentation and correspondence requiring extensive policy analysis and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available.
• Collaborates with both external and internal resources, such as physicians, attorneys, vocational consultants, and CPAs to gather data such as medical/occupational information to ensure claim decisions are well-reasoned and thorough.
• Identifies, clarifies, and reconciles inconsistencies when gathering information during claim evaluations and collaborates with underwriting and Fraud Waste and Abuse resources, as needed.
• Identifies offsets and proficiently calculates monthly benefits, to include COLA, Social Security Offsets, Residual Disability, and other non-routine payments.
• Provides timely and detailed written communication during the claim evaluation, which outlines and supports the status of the evaluation and/or claim determination.
• Addresses and resolves escalated customer complaints in a timely and thorough manner, including drafting written responses to Department of Insurance and Presidential complaints. Identifies and refers appropriate matters to litigation support partners.
• May represent the company at depositions and trials.

Skills & Requirements

• Prior experience with independent judgement and decision making.
• Critical thinking and analysis skills when reviewing information.
• Creative problem-solving abilities when working in grey areas and the ability to think outside the box.
• Excellent interpersonal and communication skills in both verbal and written form.
• Excellent customer service skills proven through internal and external customer interactions.
• Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively.
• Organizational and time management skills.
• Ability to effectively manage multiple systems and technology sources.
• 3+ years of IDI or LTD insurance claims experience.

Benefits/Other Compensation

This position is a contract/temporary role where Hays offers you the opportunity to enroll in full medical benefits, dental benefits, vision benefits, 401K and Life Insurance ($20,000 benefit).

Why Hays?

You will be working with a professional recruiter who has intimate knowledge of the industry and market trends. Your Hays recruiter will lead you through a thorough screening process in order to understand your skills, experience, needs, and drivers. You will also get support on resume writing, interview tips, and career planning, so when there’s a position you really want, you’re fully prepared to get it.

Nervous about an upcoming interview? Unsure how to write a new resume?

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Hays is committed to building a thriving culture of diversity that embraces people with different backgrounds, perspectives, and experiences. We believe that the more inclusive we are, the better we serve our candidates, clients, and employees. We are an equal employment opportunity employer, and we comply with all applicable laws prohibiting discrimination based on race, color, creed, sex (including pregnancy, sexual orientation, or gender identity), age, national origin or ancestry, physical or mental disability, veteran status, marital status, genetic information, HIV-positive status, as well as any other characteristic protected by federal, state, or local law. One of Hays’ guiding principles is ‘do the right thing’. We also believe that actions speak louder than words. In that regard, we train our staff on ensuring inclusivity throughout the entire recruitment process and counsel our clients on these principles. If you have any questions about Hays or any of our processes, please contact us.

In accordance with applicable federal, state, and local law protecting qualified individuals with known disabilities, Hays will attempt to reasonably accommodate those individuals unless doing so would create an undue hardship on the company. Any qualified applicant or consultant with a disability who requires an accommodation in order to perform the essential functions of the job should call or text 813.336.5570.

Drug testing may be required; please contact a recruiter for more information.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Part-time

Job function

• Job function

  Administrative and Customer Service

• Industries

  Insurance and Insurance Carriers

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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