Disability Claims Appeal & Complaints Analyst

Role Overview

• Analyst will handle appeals submitted on Disability (STD, LTD, Leave) products.
• Review adverse claim life decisions within STD, LTD, State Leave product line.
• Review claim files in depth and detail to determine if previous claim decision (adverse claim decision) was appropriate or if prior decision should be reversed.
• Provide high level feedback on claim handling.
• Handle appeals in line with job aids in place.
• Responsible for reviewing regulatory & presidential complaints and providing responses to appropriate agency.

Requirements

• Prior claim handling experience in fully and self-insured STD, LTD and State Leave lines of business.
• Prior Appeal handling experience in fully/self insured STD, LTD, State Leave lines of business including decision letter writing.
• Prior Complaint handling experience (regulatory, Sr. Officer, Presidential).
• Contract review and interpretation.
• Letter writing skills.
• FINEOS experience is preferred
• Microsoft office products Excel experience/knowledge PowerPoint experience

Benefits

• medical
• dental
• vision
• 401(k) plan
• paid time off