STD Claims Examiner — Hybrid Role with Competitive Benefits

Jobgether SRL; Indianapolis (IN); Hybrid; USD 34,000 - 59,000; Full time

Benefits offered by this job

Hybrid work arrangement in Indiana

Health insurance

401(k) plan

Pension plan

Paid time off

Parental leave

Life and disability insurance

Wellness program

Employee assistance program

Clinic access

Job summary

Jobgether SRL in Indianapolis, IN, seeks an experienced Short-Term Disability Claims Examiner to manage investigations, adjudication, and benefit calculations from initial review through resolution.

You will collaborate with claimants, policyholders, physicians, and internal teams, interpret policy provisions, coordinate transitions to long-term disability when appropriate, and ensure timely, compliant processing.

Qualifications

• Bachelor's degree or equivalent combination of education and relevant experience.
• 5+ years of experience managing short-term disability claims with first-pay authority.
• Strong understanding of short-term disability claims adjudication, policy interpretation, benefit calculations, and claims investigation.
• Excellent analytical and decision-making skills, with the ability to evaluate complex claim information and reach sound conclusions.
• Strong mathematical and calculation skills, particularly when determining benefits and other financial adjustments.
• Excellent customer service and communication skills, with the ability to interact professionally with claimants, policyholders, medical professionals, and internal stakeholders.
• Strong organizational skills and attention to detail, with the ability to manage multiple claims and deadlines while maintaining accurate documentation.
• Working knowledge of Microsoft Excel and Word.
• Ability to maintain confidentiality and comply with established procedures, regulatory requirements, and claims practices.
• Ability to collaborate effectively with technical resources, colleagues, and management.
• Spanish fluency, both written and spoken, is a plus.
• Candidates may be considered at Level I, Level II, or Senior level depending on their experience and qualifications.

Responsibilities

• Investigate, evaluate, and adjudicate short-term disability claims promptly and accurately in accordance with policy provisions, departmental procedures, and applicable regulations.
• Interpret contract provisions related to eligibility, covered weekly earnings, total disability definitions, offsets, pre-existing conditions, and other applicable requirements.
• Calculate benefit amounts and process financial activities, including payment adjustments, stop payments, voids, check reissues, other-income adjustments, reimbursements, final benefits, and overpayments.
• Initiate and facilitate case management and coordinate ancillary services to support appropriate claim outcomes.
• Proactively communicate with claimants, policyholders, physicians, and other stakeholders to obtain information, resolve investigation issues, and manage expectations.
• Obtain claim information through efficient and appropriate methods while maintaining complete and accurate documentation of claim actions and communications.
• Coordinate with long-term disability examiners to support appropriate transitions from STD to LTD claims.
• Engage medical, vocational, Social Security, and other technical resources at appropriate stages of the claim.
• Support subrogation activities and recovery of applicable amounts from third parties.
• Escalate claim activity outside established authority levels to supervisors or managers for review.
• Respond to customer service issues within required timeframes while maintaining a professional, accurate, and courteous service experience.
• Maintain confidentiality and consistently follow documented workflows, procedures, and unfair claims practice requirements.
• Meet or exceed departmental service, quality, and production objectives.
• Collaborate with team members and management to identify process improvement opportunities and communicate relevant client or claims trends.

Skills

Analytical thinking

Decision-making

Customer service

Communication skills

Organizational skills

Confidentiality

Excel

Word

Spanish language proficiency

Education

Bachelor's degree or equivalent

Tools

Excel

Word

Job description

Jobgether SRL in Indianapolis, IN, seeks an experienced Short-Term Disability Claims Examiner to manage investigations, adjudication, and benefit calculations from initial review through resolution.

You will collaborate with claimants, policyholders, physicians, and internal teams, interpret policy provisions, coordinate transitions to long-term disability when appropriate, and ensure timely, compliant processing.