Advanced Disability Claims Analyst
Core
Adjudicate complex disability and accelerated benefit insurance claims, determining eligibility, benefits, duration, and payment amounts while serving as the primary claim contact.
Role type
Senior claims adjudicator and process improvement lead
Builds
Disability and life insurance claim determinations
Domain
Insurance / Long-term disability
Deliverable
client delivery
Required skills
disability insurance claims adjudication, medical and financial claim assessment, regulatory compliance, stakeholder management, process optimization, litigation coordination
Preferred skills
leading process optimization initiatives, mentoring peers
Technologies
none stated
Responsibilities
Adjudicate disability and accelerated benefit insurance claims, determine eligibility, benefits, duration, and payment amounts; Request, evaluate, and interpret medical, financial, occupational, and investigative information to support claim decisions; Coordinate investigations, litigation management activities, and referrals to internal specialists and external vendors; Conduct secondary reviews, support complex claim resolution, and provide coaching and guidance to team members; Manage stakeholder relationships through proactive communication with clients, advisors, attorneys, regulators, and business partners; Identify claim risks, ensure compliance with regulatory and legal requirements, and contribute to process improvement initiatives