Remote Disability Benefit Specialist | Return-to-Work Pro

Crawford & Company; California; Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Medical, Dental and Vision Plans

401(k) Retirement Plan

Tuition Assistance

Paid Holidays, Vacation and Sick Leave

Job summary

Crawford & Company is seeking a Disability Benefit Specialist to evaluate claims, determine benefit eligibility, and guide employees toward return-to-work strategies. This remote role lets you work from your preferred environment while applying disability policies and medical/vocational insights to deliver timely decisions.

You will collaborate with claimants, employers, and clinicians, manage STD/LTD caseloads, and ensure accurate service delivery and client reporting.

Qualifications

• Bachelor's degree or equivalent experience required.
• 2+ years of STD/LTD claims adjudication.
• Experience in the TPA or self-administration services is desired.
• Experience with FMLA/State leave claims is a plus.
• Aptitude for learning medical terminology and conditions and interpreting regulations.
• Ability to work independently while assimilating various technical resources.
• Computer knowledge in Excel, Word, web-based systems, etc.
• Good verbal and written communication skills.
• Knowledge of ERISA regulations, required offsets and deductions, disability duration and SSA procedures.
• Demonstrated ability to gather/analyze information and decide course of action.
• Strong ability to identify, analyze and solve problems.
• Effective interpersonal skills with external sources and all employee levels.

Responsibilities

• Manages assigned caseload of disability claims for Short Term/Long Term Disability.
• Communicates with claimants, employers, and medical professionals to gather information.
• Applies contractual provisions and claim processes to ensure eligibility and liability decisions.
• Provides superior customer service by rendering determinations within timeframes.
• Verifies ongoing disability and participates in claim reviews with nurses, physicians, and vocational specialists.
• Uses disability claim system to manage and authorize payment while meeting standards.
• Ensures timely transition of claims from STD to LTD for a seamless experience.
• Analyzes claims activity and prepares reports for clients/carriers/management.
• Becomes familiar with client instructions and serves as a resource for trainees.
• Effectively works together in a team setting.
• Other duties as assigned.

Skills

Disability claims adjudication

Communication skills

Problem solving

Interpersonal skills

Independence

Education

Bachelor's degree or equivalent experience

Tools

Excel

Claims system

Job description

Crawford & Company is seeking a Disability Benefit Specialist to evaluate claims, determine benefit eligibility, and guide employees toward return-to-work strategies. This remote role lets you work from your preferred environment while applying disability policies and medical/vocational insights to deliver timely decisions.

You will collaborate with claimants, employers, and clinicians, manage STD/LTD caseloads, and ensure accurate service delivery and client reporting.