The Disability Claims Examiner manages assigned caseload of more complex disability cases. Evaluates claimant eligibility. Utilizes specialty consulting resources effectively including medical legal vocational and/or rehabilitative staffs to achieve optimum outcomes for claims direction. Interacts with internal and external customers including but not limited to claimants employers physicians attorneys and underwriters to gather the information to make the decision on the claim. Analyzes approves or denies Disability Income and Waiver of Premium claims for contestable and non-contestable cases. Provides technical direction to other claims personnel as needed. Decides payment period follows up and monitors payment accuracy and timeliness; follows plan to closure. Incumbents typically have 3-5 years of relevant experience. Typically reports to Supervisor of Disability Claims.

• 2+ years of disability claim management expertise


• Vendor oversight experience a plus


• Experience interfacing with Disability Claim Operation, Sales, Account Management and Clients


• Excellent communication skills, both verbal and written


• Excellent relationship building and partnership skills


• Ability to create, document and execute plans


• Ability to multitask and meet deadlines with quick turnaround time


• Excellent organization skills and high level of work discipline


• Ability to manage issues/problems from identification through resolution


• Presentation and/or training experience


• Proficiency in Excel required


• Experience with Visio, Power Point creation and other Microsoft software