Waiver of Premium Claims Specialist
Core
Investigates, analyzes, and adjudicates complex Waiver of Premium claims for active policies, determining eligibility based on medical, legal, and policy facts.
Role type
Claims adjudication specialist (Waiver of Premium)
Builds
Waiver of Premium benefit decisions for insureds
Domain
Insurance / Claims Management
Deliverable
client delivery
Required skills
Claims adjudication, medical terminology interpretation, insurance contract analysis, regulatory compliance, conflict resolution, legal document preparation
Preferred skills
Disability Income claims experience, claim management systems proficiency (DI Benefits Connection, Claims Platform), healthcare or law background
Technologies
DI Benefits Connection, Claims Platform
Responsibilities
Investigate and approve/deny complex Waiver of Premium claims; order and review medical/investigative information; manage claim files for ongoing benefit decisions; represent the company in depositions and trials; communicate with insureds, attorneys, and government agencies
Seniority
Mid-level, hands-on IC