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Remote Disability Claims Examiner Jobs in Colorado

Claims Processor II

Denver, CO · On-site +1

$22.84 - $27.40/hr

Work claims audits generated by Virtual Examiner -500-1500 weekly * Work IP audits generate by ... disability, protected veteran status, pregnancy, or any other protected status. Salaries are ...

They will have an extra focus with short term disability claims. Responsibilities * Develop and ... Hybrid and/or Remote *Please note that the compensation information that follows is a good faith ...

Reviewing denied claims via Athena worklists and payer portals * Identifying root causes of denials ... disability • Health Spending Account (HSA) • Transportation benefits • Employee Assistance ...

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Remote Disability Claims Examiner information

What does a remote disability claims examiner do?

A Remote Disability Claims Examiner evaluates disability insurance claims to determine eligibility for benefits. They review medical records, employment history, and other relevant documents while working from a remote location. The examiner communicates with claimants, healthcare providers, and sometimes employers to gather necessary information. Their primary responsibility is to ensure that claims are processed accurately, fairly, and in compliance with legal and company guidelines.

What are the key skills and qualifications needed to thrive as a remote disability claims examiner?

To thrive as a Remote Disability Claims Examiner, you need a solid understanding of insurance policies, medical terminology, and claims adjudication, typically backed by a relevant degree or prior claims experience. Familiarity with claims management software, electronic documentation tools, and regulatory compliance systems is essential. Attention to detail, strong analytical thinking, and effective written communication are standout soft skills for this role. These skills and qualities are crucial for accurately evaluating claims, ensuring regulatory compliance, and delivering fair outcomes while working independently from a remote setting.

What are some common challenges faced by remote disability claims examiners, and how can they be managed effectively?

Remote Disability Claims Examiners often encounter challenges such as evaluating complex medical documentation, communicating with claimants or healthcare providers virtually, and meeting tight deadlines. Staying organized with digital case management tools and maintaining clear, proactive communication can help manage these challenges. Additionally, regularly collaborating with team members and participating in ongoing training sessions can enhance accuracy and ensure consistency in decision-making, even in a remote work environment.

What is the difference between Remote Disability Claims Examiner vs Remote Disability Claims Adjuster?

AspectRemote Disability Claims ExaminerRemote Disability Claims Adjuster
Required CredentialsTypically requires a healthcare or insurance-related certification, such as nursing or claims certificationOften requires insurance adjuster licensing and relevant certifications
Work EnvironmentPrimarily office-based, working with medical records and reports remotelyRemote or office-based, assessing claims and interacting with policyholders
Employer & Industry UsageUsed mainly by insurance companies, government agencies, and third-party administratorsCommonly employed by insurance carriers, third-party administrators, and claims management firms

While both roles involve evaluating insurance claims remotely, the Remote Disability Claims Examiner focuses on medical and disability documentation, often requiring healthcare credentials. In contrast, the Remote Disability Claims Adjuster handles broader claims assessments, including policy interpretation and settlement, often requiring insurance licensing. Understanding these differences helps job seekers identify the right role based on their background and career goals.

What cities in Colorado are hiring for Remote Disability Claims Examiner jobs?

Cities in Colorado with the most Remote Disability Claims Examiner job openings:

Senior Claims Examiner, Professional Liability

Archgroup

Denver, CO • Remote

$111K - $172K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 16 days ago


Job description

With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility.

Position Summary

Arch Insurance Group Inc., AIGI, has an opening with our Claims Division on the Professional Liability Team with a focus on Lawyers Professional Liability. In this role, the responsibilities include actively managing Professional Liability claims in jurisdictions throughout the United States.

Responsibilities

  • Develop and implement timely and accurate resolution strategies to ensure mitigation of indemnity and expense exposure
  • Develop and implement strategy relative to coverage issues which correlate with the overall strategy of matters entrusted to the handler's care
  • Identify and assess coverage issues, draft coverage position letters, and retain coverage counsel, when necessary, as well as review coverage counsel's opinion letters and analysis
  • Maintain contact with the business line leader, underwriter, defense counsel, program manager, and broker to communicate developments and outcomes as necessary
  • Investigate claim and review the insureds' materials, pleadings, and other relevant documents
  • Identify and review each jurisdiction's applicable statutes, rules, and case law
  • Analyze and direct risk transfer, additional insured issues, and contractual indemnity issues
  • Retain counsel when necessary and direct counsel in accordance with resolution strategy
  • Analyze coverage, liability and damages for purposes of assessing and recommending reserves
  • Prepare and present written/oral reports to senior management setting forth all issues influencing evaluation and recommending reserves
  • Maintain a diary of all claims, post reserves in a timely fashion, and expeditiously respond to inquiries from the insured, counsel, underwriters, brokers, and senior management regarding claims

Experience & Required Skills

  • Exceptional communication (written and verbal), evaluating, influencing, negotiating, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines
  • Strong time management and organizational skills
  • Demonstrate the ability to take part in active strategic discussions
  • Demonstrate the ability to work well independently and in a team environment
  • Hands-on experience and strong aptitude with Microsoft Excel, PowerPoint and Word
  • Willing and able to travel 15%

Education

  • Bachelor's degree; Juris Doctorate degree required
  • Three to seven (3-7) years of working experiencewith a primary and or excess carrier, broker, or law firm supporting commercial accounts for specialty insurance claims
  • Proper & active adjuster licensing in all applicable states

#LI-SW1

#LI-REMOTE

For individuals assigned or hired to work in the location(s) indicated below, the base salary range is provided. Range is as of the time of posting. Position is incentive eligible.

$111,100- $172,465/year

  • Total individual compensation (base salary, short & long-term incentives) offered will take into account a number of factors including but not limited to geographic location, scope & responsibilities of the role, qualifications, talent availability & specialization as well as business needs. The above pay range may be modified in the future.
  • Arch is committed to helping employees succeed through our comprehensive benefits package that includes multiple medical plans plus dental, vision and prescription drug coverage; a competitive 401k with generous matching; PTO beginning at 20 days per year; up to 12 paid company holidays per year plus 2 paid days of Volunteer Time Offer; basic Life and AD&D Insurance as well as Short and Long-Term Disability; Paid Parental Leave of up to 10 weeks; Student Loan Assistance and Tuition Reimbursement, Backup Child and Elder Care; and more. Click here to learn more on available benefits.

Do you like solving complex business problems, working with talented colleagues and have an innovative mindset? Arch may be a great fit for you.If this job isn't the right fit but you're interested in working for Arch, create a job alert! Simply create an account and opt in to receive emails when we have job openings that meet your criteria. Join our talent community to share your preferences directly with Arch's Talent Acquisition team.


For Colorado Applicants - The deadline to submit your application is:

August 18, 202614400 Arch Insurance Group Inc.