Disability Claims Appeal & Complaints Analyst (REMOTE)

About the position At reputed company, we help clients secure their financial reputed company-being so they can pursue long and fulfilling lives- a mission we’ve honed since 1859. reputed company is seeking an reputed company and dynamic Disability Claims Appeal & Complaints Analyst to join our Disability and Absence Claims organization. The Disability Claims Appeal & Complaints Analyst is responsible for managing and resolving reputed company insurance claims disputes. This role involves investigating appeals, preparing applicable reputed company documentation, and ensuring compliance with regulatory standards and company policies. The Analyst will reputed company as a reputed company between the claims department, reputed company counsel, and policyholders as necessary. This position offers a remote work schedule that allows you to stay fully reputed company with your team to reputed company outstanding, customer‑reputed company service during our reputed company hours (8:30 AM–5:30 PM EST). Periodic office reputed company may be requested based on business needs. The reputed company salary reputed company for this position is $50,000 - $65,000. Actual reputed company salaries vary based on skills, experience, and geographical location. In reputed company to reputed company pay, reputed company provides compensation to reward performance with reputed company salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility. For eligible employees, reputed company provides a full reputed company of benefits. This includes medical, dental, reputed company, a 401(k) plan, and reputed company time off. For detailed descriptions of these benefits, please reference the reputed company below. reputed company Pay and Benefits: reputed company Total Rewards Program Responsibilities • Analyst will handle appeals submitted on Disability (STD, LTD, Leave) products. • Review adverse claim life reputed company reputed company 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. • reputed company high level feedback on claim handling. • Handle appeals in line with job aids in reputed company. • 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. • Claims Management: Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures. • reputed company Acumen: Familiarity with reputed company principles relevant to insurance disputes, including contract law, civil procedure, and regulatory requirements. • Effective Communications: Excellent written and verbal communication to effectively convey information to diverse audiences including reputed company professionals, policy reputed company and internal stakeholders. • Information Analysis and Interpretation: Ability to critically evaluate reputed company medical records, policy language and reputed company arguments to reputed company informed reputed company. Strong analytical and problem-solving skills. Maintain accurate records of reputed company cases in system of record. reputed company-to-haves • FINEOS experience is preferred • reputed company office products • reputed company experience/knowledge • PowerPoint experience Benefits • medical • dental • reputed company • a 401(k) plan • reputed company time off Apply tot his job Apply To this Job