Recertification Claims Specialist

About Our Client

The organization operates within the financial services industry, providing insurance and retirement solutions that help individuals and businesses achieve long-term financial security. With more than 120 years of experience, it offers products including annuities, life insurance, group protection, and retirement services while serving millions of customers nationwide.

About the Opportunity

The Recertification Claims Specialist reviews approved long-term disability claims to determine whether ongoing benefits remain appropriate under changing claim definitions and circumstances. This role supports accurate, timely, and compliant claim decisions by analyzing medical information, coordinating with internal and external stakeholders, and providing compassionate service to claimants.

Responsibilities

• Review approved long-term disability claims for changes in definition and determine appropriate next steps.
• Communicate with claimants, employers, medical professionals, and other stakeholders by phone and email to obtain relevant information.
• Collaborate with case managers, nurse case managers, vocational case managers, and consulting physicians to support timely and well-informed claim decisions.
• Analyze complex medical records using available tools and resources to determine appropriate approval durations and future claim actions.
• Document claim activity and decisions accurately and thoroughly.
• Apply claim policies, procedures, and applicable requirements consistently throughout the review process.
• Manage assigned claims efficiently while meeting quality and productivity expectations.
• Provide proactive, professional, and compassionate customer service throughout the claims process.

Requirements

• High school diploma or GED required; an Associate degree may substitute for required experience.
• 3–5 years of direct long-term disability claims experience, or 0–1 year of experience with an Associate degree.
• Strong written and verbal communication skills.
• Excellent organizational, analytical, and multitasking abilities.
• Ability to review and interpret complex medical and claim information.

Preferred Qualifications

• Experience with disability claims and/or absence management.

Pay

Salary range of $55,700–$100,200 per year, with anticipated starting pay generally between the minimum and midpoint of the range. Actual compensation may vary based on experience, education, location, licensure, qualifications, and other relevant factors.

Eligibility for an Annual Incentive Program based on company, business unit, and individual performance. Additional rewards may include long-term incentives, sales incentives, and standard employee benefits.

Benefits & Perks

• Competitive 401(k) retirement plan.
• Tuition assistance program.
• Paid time off and parental leave.
• Financial counseling and health coaching.
• Employee assistance programs.
• Flexible work arrangements.