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Disability Claims & Underwriting Specialist

Weekday
Remote, USA
Contract
Junior · 2+ years experience
Remote
Discovered 3 days ago

Full Job Posting

Requirements

  • What You'll Do
  • Design realistic scenarios involving short- and long-term disability claims, elimination periods, own-occupation and any-occupation definitions, residual and partial disability, offsets, recurrent disability and claim duration management
  • Create work products such as claim determinations, benefit calculations, medical and vocational evidence summaries, transferable-skills analyses, return-to-work plans and appeal decisions
  • Write "golden" reference responses at experienced disability-professional quality
  • Grade AI-generated responses against structured rubrics for definitional accuracy, evidentiary support, benefit-calculation correctness and procedural fairness
  • Identify misapplied disability definitions, unsupported functional conclusions, missed offsets, incorrect benefit math, and failures to document the administrative record
  • Provide written feedback the research team uses to improve model behavior
  • Participate in onboarding office hours and calibration sessions
  • You're a Good Fit If You
  • Have 2+ years of professional experience in disability claims adjudication, disability underwriting, vocational rehabilitation, or leave and absence management
  • Have worked with at least one program type, such as group short-term disability, group long-term disability, individual disability income, statutory disability, or life waiver of premium
  • Understand how contract definitions, elimination periods, offsets, pre-existing-condition provisions and maximum benefit periods determine entitlement and duration
  • Can weigh medical, occupational and financial evidence and articulate a defensible determination with a documented rationale
  • Demonstrate excellent written analysis, balanced judgment and high attention to detail
  • Can distinguish claim adjudication from treating-provider clinical decisions and from formal legal advice
  • Bonus Qualifications
  • CRC, CDMS, CCM, CPDM, RN, or comparable clinical or vocational credential
  • Experience with ERISA administrative records, appeals or litigation support
  • Individual disability income underwriting, including occupation class and financial underwriting
  • Social Security, workers compensation or other-income offset coordination experience
  • Experience with FMLA, state leave programs or ADA accommodation interaction
  • Role Highlights
  • Minimum 20 hours per week (ideally 40+)
  • Role starts immediately, applications reviewed on a rolling basis
  • We consider all qualified applicants without regard to legally protected characteristics and provide reasonable accommodations upon request.

Preferred Qualifications

  • Bonus Qualifications

Responsibilities

  • Design realistic scenarios involving short- and long-term disability claims, elimination periods, own-occupation and any-occupation definitions, residual and partial disability, offsets, recurrent disability and claim duration management
  • Create work products such as claim determinations, benefit calculations, medical and vocational evidence summaries, transferable-skills analyses, return-to-work plans and appeal decisions
  • Write "golden" reference responses at experienced disability-professional quality
  • Grade AI-generated responses against structured rubrics for definitional accuracy, evidentiary support, benefit-calculation correctness and procedural fairness
  • Identify misapplied disability definitions, unsupported functional conclusions, missed offsets, incorrect benefit math, and failures to document the administrative record
  • Provide written feedback the research team uses to improve model behavior
  • Participate in onboarding office hours and calibration sessions
  • You're a Good Fit If You
  • Have 2+ years of professional experience in disability claims adjudication, disability underwriting, vocational rehabilitation, or leave and absence management
  • Have worked with at least one program type, such as group short-term disability, group long-term disability, individual disability income, statutory disability, or life waiver of premium
  • Understand how contract definitions, elimination periods, offsets, pre-existing-condition provisions and maximum benefit periods determine entitlement and duration
  • Can weigh medical, occupational and financial evidence and articulate a defensible determination with a documented rationale
  • Demonstrate excellent written analysis, balanced judgment and high attention to detail
  • Can distinguish claim adjudication from treating-provider clinical decisions and from formal legal advice
  • Bonus Qualifications
  • CRC, CDMS, CCM, CPDM, RN, or comparable clinical or vocational credential
  • Experience with ERISA administrative records, appeals or litigation support
  • Individual disability income underwriting, including occupation class and financial underwriting
  • Social Security, workers compensation or other-income offset coordination experience
  • Experience with FMLA, state leave programs or ADA accommodation interaction
  • Role Highlights
  • Minimum 20 hours per week (ideally 40+)
  • Role starts immediately, applications reviewed on a rolling basis
  • We consider all qualified applicants without regard to legally protected characteristics and provide reasonable accommodations upon request.

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