| Disability Claims Examiner I Job Description |
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| The following is a full job description for Disability Claims Examiner I. Here are the requirements and responsibilities for Disability Claims Examiner I along with statistics. If after reading this page you determine that Disability Claims Examiner I is not the position you are looking for, you may want to try one of these similar titles: Disability Claims Examiner III, Claims Examiner I, Disability Claims Examiner II, Claims Examiner III, Claims Examiner IV, Claims Examiner II, Medical Claims Examiner I, Disability Claims Manager, Claims Adjuster I - P&C |
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| Requirements and Responsibilities For Disability Claims Examiner I |
| Examines and adjudicates short- and long-term disability claims to determine eligibility, benefits, and ongoing entitlement under plan provisions. Reviews medical documentation, occupational information, and financial records to evaluate the validity of claims. Assesses plan definitions, regulatory guidelines, and clinical guidance to make accurate benefit determinations. Coordinates with claimants, physicians, and vocational or clinical resources to obtain and assess relevant information. Calculates benefit amounts, manages offsets, and documents decisions and rationale within the claims system. Ensures compliance with ERISA, state regulations, and company service standards. Requires a bachelor's degree. Typically reports to a manager. Work is closely managed. Works on projects/matters of limited complexity in a support role. Typically requires 0-2 years of related experience. |
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| Also referred to as: Disability Claims Reviewer I |
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| Similar Jobs: Disability Claims Examiner III, Claims Examiner I, Disability Claims Examiner II, Claims Examiner III, Claims Examiner IV, Claims Examiner II, Medical Claims Examiner I, Disability Claims Manager, Claims Adjuster I - P&C |
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| Level of Education: Disability Claims Examiner I Salaries with No Diploma, Disability Claims Examiner I Salaries with a High School Diploma or Technical Certificate, Disability Claims Examiner I Salaries with an Associate's Degree, Disability Claims Examiner I Salaries with a Bachelor's Degree, Disability Claims Examiner I Salaries with a Master's Degree or MBA, Disability Claims Examiner I Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
