Claims Examiner - (Latham, NY)

The main objective of the Claims Examiner role is to interpret medical and contractual details in the assessment of benefits payable under disability contracts while providing excellent customer service both in written and spoken communication You'll be responsible for an independent case load, but will work within a collaborative small team environment based in Latham, New York. Essential responsibilities: Determines eligibility, benefit amount/duration and certifies that the claim proofs submitted meet the definition of total disability under the provisions of the contract. Handles telephone inquires relative to claims status and makes outbound calls for acquiring info necessary to validate and adjudicate claims. Performs investigations involving Pre-existing and Contestable conditions. This includes requesting medical records and evaluating their content upon receipt and making written recommendations to the carrier on action to be taken on these cases.