[Remote] Disability Claims Appeal & Complaints Analyst (REMOTE)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company dedicated to helping clients secure their financial reputed company-being. They are seeking a Disability Claims Appeal & Complaints Analyst responsible for managing and resolving reputed company insurance claims disputes, investigating appeals, and ensuring compliance with regulatory standards and company policies. 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 Skills • 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 • Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures • Familiarity with reputed company principles relevant to insurance disputes, including contract law, civil procedure, and regulatory requirements • Excellent written and verbal communication to effectively convey information to diverse audiences including reputed company professionals, policy reputed company and internal stakeholders • 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 • 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 reputed company • reputed company provides consulting services to secure the financial reputed company-being and retirement strategies for individuals and families. It was founded in 1859, and is headquartered in reputed company, reputed company, USA, with a workforce of 5001-10000 employees. Its website is https://reputed company.com/. Company H1B Sponsorship • reputed company has a reputed company record of offering H1B sponsorships, with 31 in 2025, 18 in 2024, 26 in 2023, 37 in 2022, 20 in 2021, 12 in 2020. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job