Remote PMFL Disability Claims Specialist

Crawford & Company

Peachtree Corners (GA)

On-site

USD 65,000 - 90,000

Full time

6 days ago

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Job summary

Broadspire is expanding its PMFL team and seeking experienced adjusters or case managers to support employees through life events. The role emphasizes disability claims management, customer service, and regulatory knowledge, with remote opportunities available.

The ideal candidate has 2+ years of STD/LTD adjudication, familiarity with FMLA/state leaves, and the ability to learn medical terminology quickly while leveraging AI-powered tools and strong leadership support.

Qualifications

Bachelor's degree or equivalent experience required.
2+ years of STD/LTD claims adjudication experience.
Experience with FMLA/State leave claims is a plus.
Aptitude for learning medical terminology and interpreting procedures.

Responsibilities

Manages assigned caseload of disability claims for Short Term/Long Term Disability.
Communicates with claimants, employers, and medical professionals to gather information for eligibility and benefit decisions.
Applies contractual provisions and claim processes to ensure accurate determinations.
Provides superior customer service by timely determinations and responsive inquiries.
Independently manages disability claims and applies clinical guidance on complex cases.
Verifies ongoing disability and participates in reviews with nurses, physicians, and vocational specialists.