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Remote Disability Claims Examiner Jobs in Michigan

Remote / Hybrid (dependent upon on proximity of office location) Reports To: Katie Toman Employment ... Basic life and disability insurance * 401(k) plan with 6% company match * 20 days of PTO and two ...

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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 are popular job titles related to Remote Disability Claims Examiner jobs in Michigan?

For Remote Disability Claims Examiner jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Remote Disability Claims Examiner jobs in Michigan look for?

The top searched job categories for Remote Disability Claims Examiner jobs in Michigan are:

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

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

Disability Examiner 9-P11 - Kalamazoo

State of Michigan

Lansing, MI • On-site, Remote

$25.89 - $38.36/hr

Full-time

Posted 16 days ago


State Of Michigan rating

8.0

Company rating: 8.0 out of 10

Based on 189 frontline employees who took The Breakroom Quiz

10th of 50 rated states


Job description

Job Description The Michigan Department of Health and Human Services mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect, and fairness. For more information, please visit MDHHS Diversity Equity and Inclusion.

The Disability Examiner is responsible for learning and demonstrating competency with complex Social Security disability insurance program standards as applied to medical and vocational evidence. The Examiner will assist in developing disability claims with assistance and oversight from Trainers, Supervisors Mentors and Medical Consultant staff. The Examiner will receive case assignment reviews gradually increasing in number and complexity so as to assess the ability to analyze large volumes of evidence in electronic case folders during the probationary period.

The Examiner will learn to access information electronically and use electronic case processing software. Individuals selected for positions with the Michigan Disability Determination Service (DDS) will be required to pass a complete federal background investigation as required by Homeland Security Presidential Directive 12 (HSPD-12). A suitability determination by the Social Security Administration is necessary to determine whether an employee can be issued credentials in order to have access to Social Security Disability data, records, and systems.

Finalists must pass a preliminary check prior to a job offer being made. A full background investigation will follow. Further details will be provided during the interview process.

Position Description Job Specification To be considered for this position you must: Apply for this position online via NEOGOV; click on "Apply" in the job posting for instructions in submitting your electronic application. Hard copy applications are not accepted. Attach a resume identifying specific experience and dates of employment.

Dates of employment should include month and year and hours per week. Attach a cover letter. Attach a copy of an official transcript(s).

We accept scanned copies of official transcripts. We do not accept web-based, internet, or copies of unofficial transcripts. Official transcripts provide the name of the institution, confirmation that a degree was awarded and on what date, and the registrar's signature.

Failure to complete any of the above items may result in your application not being considered. See instructions for attaching files here: Instructions Required Education and Experience Education Possession of a bachelor's degree with any major. Experience Disability Examiner 9 No specific type or amount is required.

Disability Examiner 10 One year of professional experience adjudicating, analyzing, and determining eligibility for disability claims equivalent to a Disability Examiner 9. Disability Examiner P11 Two years of professional experience adjudicating, analyzing, and determining eligibility for disability claims equivalent to a Disability Examiner, including one year equivalent to a Disability Examiner 10. Alternate Education and Experience Possession of a master's degree with a major in Rehabilitation Counseling, Guidance and Counseling, Special Education, Social Work, Psychology, Child Development, Sociology, Nursing, Physician Assistant, Pre-Medical Vocational Rehabilitation, Clinical Psychology, Health, Physical Therapy, Anatomy, or Bio-Physics may be substituted for six months of professional experience in the evaluation and/or adjudication of disability claims.

Credit for a master's degree can be used only once during the progression of a position from the entry (9) level to the intermediate (10) level, from the intermediate (10) level to the experienced (P11) level, or from the experienced (P11) level to the senior (12) level. Additional Requirements and Information Your application for any position does not guarantee that you will be contacted by the Department/Agency for further consideration. Only those applicants interviewed will be notified of the results.

The physical location of this position is 427 E. Alcott Street, Kalamazoo, MI. Based on operational needs and within established limits, remote work and alternate or hybrid work schedule requests for this position may be considered.

Selected candidates who have been approved to work remotely or a hybrid schedule must complete that work within Michigan. Candidates should confirm work location and schedule at the time of interview. Employees will be provided computers to perform state work.

Phones may also be provided for necessary communications. If working remotely, employees will be responsible for providing other components of a remote office at their own expense, including: A secure work location that allows privacy and prevents distractions. A high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.

Suitable lighting, furniture, and utilities. This position is open to all applicants but preference may be given to current Michigan Department of Health and Human Services (MDHHS) employees and MDHHS employees in lay-off status. The Department reserves the right to close this posting prior to its original end date once a sufficient number of applications have been received.

The use of artificial intelligence (AI) software of any kind is prohibited in all areas of the selection process; including, but not limited to, responses to application questions, and responses to interview questions or exercises. If you previously held status in this classification and departed within the last three (3) years, please contact Human Resources regarding your interest in a potential reinstatement. Reinstatement is not guaranteed or required.

Questions related to this position may be directed to Steve Mayer at MayerS@michigan.gov or Kim Swan at Kimberly.K.Swan@ssa.gov. Follow us on LinkedIn for more job opportunities. MDHHSJobs #MDHHSJobs #Veteranfriendly #CareersWithPurpose #CommunityHeroes MDHHS is proud to be a Michigan Veteran's Affairs Agency (MVAA) Gold Level Veteran-Friendly Employer

Accommodations If you require a reasonable accommodation to participate in the application or selection processes, please contact the ADA coordinator for the agency that posted this position vacancy.


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