Disability Claims Specialist (IDI/LTD)

Job Title: Disability Claims Consultant
Location: Fully Remote (40 hrs/week)
Work Hours: Flexible between 7:30 AM 5:30 PM EST
Duration: 12-Month Contract
Client: Direct-client

Client is seeking a Disability Claims Consultant to join their team and support their mission of making a meaningful impact in the lives of their customers and communities. In this role, you will evaluate Individual Disability Income (IDI) and Long-Term Disability (LTD) insurance claims , exercising independent judgment to ensure accurate and timely claim determinations. The ideal candidate will demonstrate strong critical thinking, risk management, customer service, and case management skills.

• Independently manage an assigned caseload of moderately complex disability claims (pending, ongoing, disputed, and appeals).

• Evaluate claims in accordance with policy provisions, state, and insurance department regulations.

• Provide clear, timely, and well-documented written communications regarding claim status and determinations.

• Communicate effectively with claimants, customers, healthcare providers, attorneys, brokers, and family members throughout the claims process.

• Analyze case information, identify gaps, and determine the need for additional documentation to make logical and well-reasoned decisions.

• Collaborate with physicians, attorneys, vocational consultants, CPAs, underwriting, and Fraud/Waste/Abuse resources as needed.

• Calculate benefits including COLA, Social Security Offsets, Residual Disability, and other non-routine payments.

• Address and resolve escalated complaints, including Department of Insurance and Presidential-level issues.

• Prepare documentation for potential litigation and, when required, represent client at depositions or trials.

• 5+ years of LTD insurance experience or 3+ years of IDI claims experience (IDI experience strongly preferred).

• Proven ability to exercise independent judgment and make sound decisions.

• Strong critical thinking, analytical, and problem-solving skills.

• Ability to manage multiple systems and technology platforms efficiently.

• Exceptional written and verbal communication skills.

• Excellent customer service and interpersonal abilities.

• Strong organizational and time management skills with the ability to thrive in a fast-paced environment.

• Bachelor's degree.

• 5+ years of Individual Disability Insurance (IDI) claims experience .