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Posted: 10/16/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in analyzing and managing disability claims, ensuring compliance with ERISA regulations and effective communication with claimants and providers. Proficient in medical management practices and skilled in negotiation and organizational strategies.
Highest-signal resume keywords
Disability Claims ManagementERISA Regulations KnowledgeMedical Terminology ProficiencyAnalytical SkillsNegotiation Skills
About the role
Key responsibilities & impact- Analyze, approve, and authorize assigned disability claims and determine benefits due under disability plans
- Review complex medical information to determine whether claimants are disabled under the applicable plan
- Use clinical resources in case assessment
- Communicate with claimants and providers regarding the claims process and return-to-work expectations
- Determine benefits due and make timely claims payments, approvals, and adjustments for workers compensation, SSDI, and other disability offsets
- Medically manage disability claims in compliance with duration control guidelines and plan provisions
- Inform claimants about required documentation, time frames, payment information, and claims status
- Coordinate investigative efforts and review contested claims
- Arrange referrals to outside vendors or physician advisors for surveillance, independent medical evaluations, functional capability evaluations, and related disability activities
- Negotiate return to work with or without job accommodations through claimants' physicians and employers
- Refer cases to team leads and clinical case management as appropriate
- Maintain professional client relationships
- Support organizational quality programs and perform other assigned duties
Requirements
What you’ll need- Bachelor's degree from an accredited university or college preferred
- Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience required
- Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
- Working knowledge of medical terminology and duration management
- Excellent oral and written communication, including presentation skills
- PC literacy, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Ability to work in a team environment
- Excellent negotiation skills
- Ability to meet or exceed Performance Competencies
- Credit security clearance, confirmed via a background credit check, is required
Benefits
Comp & perks- Medical insurance
- Dental insurance
- Vision insurance
- 401k and matching
- PTO
- Disability insurance
- Life insurance
- Employee assistance
- Flexible spending or health savings account
- Other additional voluntary benefits
- Reasonable accommodations
- Drug-free workplace
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Claims AnalysisBenefits DeterminationMedical Management PracticesDocumentation ReviewClaims Payment ProcessingDuration ManagementSocial Security Application Procedures
Soft Skills
Excellent CommunicationStrong Organizational SkillsTeam CollaborationPresentation Skills
Tools & Technologies
Microsoft Office
Certifications & Qualifications
Credit Security Clearance
Industry Keywords
Disability ClaimsWorkers CompensationSSDIClaims ProcessReturn-to-Work Negotiation