Disability Claims Examiner jobs in Maine
Disability Claims Examiner reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner typically reports to a supervisor/manager. To be a Disability Claims Examiner typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)
Recently Added Disability Claims Examiner jobs
Long Term Disability Claims Examiner
- Reliance Matrix
-
South Portland, ME
FULL_TIME
-
Job Responsibilities And Requirements
The Claim Examiner II obtains and analyzes information to make claim decisions and payments on Long Term Disability “LTD” and Waiver of Premium “WOP” claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy.
To learn more about the Claim Examiner II position, watch our exclusive employee video!
Duties and Responsibilities:- Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim.
- Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line.
- Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner.
- Conducts in-depth pre-existing condition or contestable investigations if applicable.
- Calculates benefit payments, which may include partial disability benefits, integration with other income sources, survivor benefits, residual disability benefits, cost of living adjustments, etc.
- Develops and maintains on-line claim data (and paper file if applicable).
- Provide customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.
- Fully investigates and adjudicates a large volume simple to complex claims.
- Identifies and investigates change in Total Disability definition (any occ).
- Independently reviews and manage claims with high degree of complexity within the $1,500 per month approval authority limit.
- Independently makes the determination if a policyholder with life policy up to $125,000 is eligible for a waiver of premium.
- Majority of work is not subject to supervisor review and approval.
- Independently manages assigned case load as outlined in LTD Key Measures
- Collaborates with team members and management in identifying and implementing improvement opportunities.
- Remains current with all corporate and disability management practices.
- Collaborates with team members and management in identifying and implementing improvement opportunities.
- Collaborates with management on claims with high degree of complexity.
- Any other job-related duty as deemed appropriate by management.
- or equivalent experience gained from any combination of formal education, on-the-job training, and/or work and life experience*
- High School Diploma or GED. Associates degree in Business, Finance, Social Work, or Human Resources preferred. Level I LOMA designation preferred.
- 2 years experience processing long term disability claims.
- Demonstrated understanding of claim management techniques and critical thinking in activities requiring analysis and/or investigation.
- Experience working in confidential/protected identification environments.
- Knowledge of medical terminology.
- Good math and calculation skills.
- Proven ability to work well in a high-visibility, public-oriented environment.
- Customer Service: Promptly acknowledges customers' needs, both internal and external. Ensures customers' needs are handled in a timely and appropriate manner. Creates a positive impression.
- Communication/Relationship Skills: Demonstrates effective interpersonal and listening skills: takes direction, practices active listening, accepts feedback. Communicate/respond appropriately to varied audiences/tasks. Exhibits teamwork, honors commitments.
- Problem Solving/Decision Making: Anticipates, analyzes and defines problems. Develops and assesses alternative solutions as necessary. Makes appropriate decisions in a timely manner. Analyzes impact of decisions.
- Productivity: Work is accomplished quickly and accurately. Takes responsibility for actions. Prioritizes work effectively and uses time efficiently. Accomplishes goals and objectives.
- Dependability: Makes/fulfills commitments. Consistently works independently, meets deadlines, and accepts responsibility for his/her actions. Adheres to all attendance requirements. Prompt, well prepared and ready to contribute.
Work location may be flexible if approved by the Company.
What We Offer
At Reliance Matrix, we believe that creating a more diverse, equitable and inclusive culture allows us to realize more of our potential. And we can’t do this without our most important asset—you.
That is why we offer a competitive pay package and a range of benefits to help team members thrive in their financial, physical, and mental wellbeing.
Our Benefits:- An annual performance bonus for all team members
- Generous 401(k) company match that is immediately vested
- A choice of three medical plans (that include prescription drug coverage) to suit your unique needs. For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
- Multiple options for dental and vision coverage
- Company provided Life & Disability Insurance to ensure financial protection when you need it most
- Family friendly benefits including Paid Parental Leave & Adoption Assistance
- Hybrid work arrangements for eligible roles
- Tuition Reimbursement and Continuing Professional Education
- Paid Time Off, volunteer days, community partnerships, and Employee Assistance Program
- Ability to connect with colleagues around the country through our Employee Resource Group program and our Diversity Equity & Inclusion Council
- Integrity
- Empowerment
- Compassion
- Collaboration
- Fun
Reliance Matrix is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability, or any other classification or characteristic protected by federal or state law or regulation. We assure you that your opportunity for employment depends solely on your qualifications.
- 4 Days Ago
ME - 1099 Property Claims Adjuster
- Copper Claims Services, Inc.
-
Portland, ME
FULL_TIME
- 1099 Property Claims Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions fo...
- 18 Days Ago
Mental Health Attorney
- Disability Rights Maine
-
Augusta, ME
FULL_TIME
- MENTAL HEALTH ADVOCACY ATTORNEYDisability Rights Maine, a progressive non-profit organization whose mission is to advance justice and equality by enforcing rights and expanding opportunities for peopl...
- 7 Days Ago
Attorney
- Disability Rights Maine
-
Augusta, ME
FULL_TIME
- Civil Rights AttorneyDisability Rights Maine, a progressive non-profit organization whose mission is to advance justice and equality by enforcing rights and expanding opportunities for people with dis...
- 10 Days Ago
Field Roof Technician
- Hancock Claims Consultants
-
Portland, ME
CONTRACTOR
- CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
- 4 Days Ago
Field Roof Technician
- Hancock Claims Consultants Technicians
-
Portland, ME
CONTRACTOR
- CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
- 27 Days Ago
Disability Claims Examiner jobs at Popular Companies
High School ELA Teacher
- Uncommon Schools
-
Camden, NJ
- Company Description Uncommon Schools is a nonprofit network of high-performing, public charter schools providing an outs...
- 6/11/2024 12:00:00 AM
Pharmacy Technician
- MEDSTAR HEALTH
-
Baltimore, MD
- General Summary of Position MedStar Health is looking for pharmacy technicians in the Baltimore area! Join one of the la...
- 6/11/2024 12:00:00 AM
Health & Safety Coordinator
- Heidelberg Materials US, Inc.
-
Vancouver, WA
- AutoReqId: 20095BR Pay Class: Salaried Exempt Minimum Pay Rate: $82,660.00 Maximum Pay Rate: $113,657.50 Department: Hea...
- 6/11/2024 12:00:00 AM
Physician - Occupational Medicine/Compensation-Pension (Loan Repayment-Recruitment Incentive)
- Veterans Health Administration
-
Saint Cloud, MN
- Summary The St. Cloud VAHCS is looking to hire a physician who will be assigned to Occupational Medicine and Compensatio...
- 6/11/2024 12:00:00 AM
Claims Examiner
- Manpower
-
El Segundo, CA
- Our client, Legal Industry is seeking a Claims Examiner to join their team. As a Legal Claims Examiner you will be part ...
- 6/11/2024 12:00:00 AM
GENERAL ENGINEER
- U.S. Pacific Fleet
-
Bremerton, WA
- Summary You will serve as a PROJECT ENGINEER in the Test Engineering & Planning Division (Code 121) of PSNS and IMF. Thi...
- 6/11/2024 12:00:00 AM
Data Analyst Manager
- Genworth
-
Richmond, VA
- POSITION TITLE Data Analyst Manager Data Insights & Strategy Committee LOCATION Richmond, VA (hybrid) Lynchburg, VA (hyb...
- 6/11/2024 12:00:00 AM
Audiologist
- Loyal Source Government Services
-
Seattle, WA
- Give Back to Those that Gave to Us We offer full- and part-time positions with excellent benefits – opportunities for gr...
- 6/10/2024 12:00:00 AM
About Maine
To the south and east is the Atlantic Ocean and to the north and northeast is New Brunswick, a province of Canada. The Canadian province of Quebec is to the northwest. Maine is both the northernmost state in New England and the largest, accounting for almost half of the region's entire land area. Maine is the only state in the continental US to border only one other American state (New Hampshire to the South and West).
Maine is the easternmost state in the United States in both its extreme points and its geographic center. The town of Lubec is the easternmost organized settlement in the United...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disability Claims Examiner jobs
$48,888 to $60,697