Manage an assigned caseload of moderately complex claims, including pending, ongoing/active, and appeal reviews. Communicate proactively with claimants and/or their representatives to gather essential details and provide clear updates.
Numbers & Facts
Location
Hometown, IL (Remote)
Salary
$40–$50 Per Hour
Description
Pay Rate: $50.00 per hour
Work Mode: Fully Remote
Summary:
20 hours per week - availability needed during core workdays and hours; Monday – Friday, 7:00AM – 5:00PM local time
Must be available to work EST hours during training
Responsibilities:
Manage an assigned caseload of moderately complex claims, including pending, ongoing/active, and appeal reviews
Provide timely, balanced, and accurate claims reviews, documentation, and recommended decisions
Communicate proactively with claimants and/or their representatives to gather essential details and provide clear updates
Interact and communicate effectively with claimants, customers, attorneys, brokers, and family members
Compile file documentation and correspondence requiring extensive policy and factual detail
Collaborate with external and internal resources to gather necessary data for claims evaluation
Calculate monthly benefits due after elimination period, including Social Security Offsets and Rehab Return to Work benefits
Provide detailed written communication during the claim evaluation process
Address and resolve escalated customer complaints in a timely and thorough manner
Requirements:
Minimum 3 years of LTD/IDI Insurance Claims experience
Experience with independent judgment and decision-making
Ability to demonstrate critical thinking and analysis
Creative problem-solving abilities
Excellent interpersonal and communication skills in both verbal and written form
Proven customer service skills through internal and external interactions
Demonstrated conceptual thinking and risk management skills