Disability Insurance Claims Specialist

Job Title: Business Analyst / Disability Insurance Claims Specialist Duration: Part time role.(20 hours a week)Location: RemoteShift hours: 7:00 am - 5:00pmPay range: $40/hr - $50/hrWorking days: Mon - Fri Key Responsibilities:Effectively manages with some level of oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicatorsProvides timely, balanced, and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulationsProvides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information, and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skillsInteracts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluationsCompiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information availableCollaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions.Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as neededProficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine paymentsProvides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination.Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas. Qualifications:3+ years of LTD/IDI Insurance Claims experiencePrior experience with independent judgement and decision making while relying on the available factsBe able to demonstrate the use of critical thinking and analysis when reviewing the informationCreative problem-solving abilities and the ability to think outside the boxExcellent interpersonal and communication skills in both verbal and written formExcellent customer service skills proven through internal and external customer interactionsDemonstrated conceptual thinking, risk management, ability to handle complex situations effectivelyOrganizational and time management skills Dexian is a leading provider of staffing, IT, and workforce solutions with over 12,000 employees and 70 locations worldwide. As one of the largest IT staffing companies and the 2nd largest minority-owned staffing company in the U.S., Dexian was formed in 2023 through the merger of DISYS and Signature Consultants. Combining the best elements of its core companies, Dexian's platform connects talent, technology, and organizations to produce game-changing results that help everyone achieve their ambitions and goals. Dexian's brands include Dexian DISYS, Dexian Signature Consultants, Dexian Government Solutions, Dexian Talent Development and Dexian IT Solutions. Visit https://dexian.com/ to learn more. Dexian is an Equal Opportunity Employer that recruits and hires qualified candidates without regard to race, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.  Saniya InamdarTechnical RecruiterPhone: 201-595-0351www.dexian.comEmail: LinkedIn: linkedin.com/in/saniya-inamdar-40839720bGot feedback? Please email Search & Apply for more jobs @ https://dexian.com