Disability Claims Specialist - REMOTE

Job Title: Disability Claims Specialist (Part-Time)

Location: Fully Remote

Employment Type: Part-Time (20 Hours per Week)

Schedule: Monday – Friday, between 7:00 AM – 5:00 PM (Local Time)

Note: Candidates who receive an offer will be required to successfully complete a background check and drug test as a condition of employment.

Position Overview

We are seeking an experienced Disability Claims Specialist to evaluate Long-Term Disability (LTD) and Individual Disability Insurance (IDI) claims in accordance with policy provisions and established service standards.

This role requires strong analytical ability, sound judgment, and excellent customer service skills while managing a caseload in a fast-paced, remote environment. The specialist will interact directly with claimants, medical professionals, attorneys, and internal stakeholders to ensure fair, accurate, and timely claims determinations.

This is a part-time remote opportunity requiring approximately 20 hours per week, with availability during standard business hours.

Key Responsibilities

• Manage an assigned caseload of moderately complex disability claims, including pending, ongoing, and appeal reviews.
• Evaluate claims based on policy provisions, medical information, occupational data, and regulatory requirements.
• Conduct frequent telephone outreach to claimants or their representatives to gather necessary information regarding medical conditions, treatment, and occupational details.
• Document all communications and claim activity accurately and promptly within the claims system.
• Provide clear, professional written and verbal communication regarding claim status, decisions, and next steps.
• Collaborate with internal and external partners including physicians, attorneys, clinical consultants, and vocational specialists to gather information required for claim evaluations.
• Identify and resolve discrepancies in claim information and escalate concerns when necessary, including potential fraud or abuse cases.
• Calculate monthly disability benefits including COLA adjustments, Social Security offsets, and return-to-work benefits.
• Address escalated customer concerns and direct complex matters to appeals or litigation support teams when appropriate.
• Maintain compliance with state regulations and Department of Insurance requirements.

Required Qualifications

• Minimum 3+ years of experience handling LTD or IDI insurance claims
• Bachelor’s degree
• Ability to exercise independent judgment and decision-making
• Strong critical thinking and analytical skills
• Proven problem-solving abilities and attention to detail
• Excellent written and verbal communication skills
• Demonstrated customer service experience
• Strong organizational and time management skills
• Ability to manage multiple priorities in a fast-paced environment

Work Schedule

• Part-Time: Approximately 20 hours per week
• Must be available during core business hours (Monday – Friday, 7:00 AM – 5:00 PM local time)
• This role does not support evening or weekend schedules