| Disability Claims Examiner II Job Description |
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| The following is a full job description for Disability Claims Examiner II. Here are the requirements and responsibilities for Disability Claims Examiner II along with statistics. If after reading this page you determine that Disability Claims Examiner II is not the position you are looking for, you may want to try one of these similar titles: Disability Claims Examiner III, Claims Examiner II, Disability Claims Examiner I, Claims Examiner I, Claims Examiner III, Claims Examiner IV, Medical Claims Examiner II, Disability Claims Manager, Claims Adjuster II - P&C |
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| Requirements and Responsibilities For Disability Claims Examiner II |
| 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. Occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. Typically requires 2-4 years of related experience. |
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| Also referred to as: Disability Claims Reviewer II |
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| Similar Jobs: Disability Claims Examiner III, Claims Examiner II, Disability Claims Examiner I, Claims Examiner I, Claims Examiner III, Claims Examiner IV, Medical Claims Examiner II, Disability Claims Manager, Claims Adjuster II - P&C |
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| Level of Education: Disability Claims Examiner II Salaries with an Associate's Degree, Disability Claims Examiner II Salaries with a Bachelor's Degree, Disability Claims Examiner II Salaries with a Master's Degree or MBA, Disability Claims Examiner II Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
