Disability Claims Appeal & Complaints Analyst (REMOTE)

About the Role

At reputed company, we help clients secure their financial well-being so they can pursue long and fulfilling lives- a mission we've honed since 1859. reputed company is seeking an influential 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 legal documentation, and ensuring compliance with regulatory standards and company policies. The Analyst will act as a liaison between the claims department, legal counsel, and policyholders as necessary. What You'll Be Doing

• Analyst will handle appeals submitted on Disability (STD, LTD, Leave) products.
• Review adverse claim life decisions 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.
• Provide 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.

This position offers a remote work schedule that allows you to stay fully engaged with your team to provide outstanding, customer‑focused service during our core hours (8:30 AM-5:30 PM EST). Periodic office visits may be requested based on business needs. The reputed company salary range for this position is $50,000 - $65,000. Actual reputed company salaries vary based on skills, experience, and geographical location. In addition 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 range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below. reputed company Pay and Benefits: reputed company Total Rewards Program What You Will Bring

• 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.

Preferred Qualifications

• FINEOS experience is preferred
• reputed company office products
• reputed company experience/knowledge
• PowerPoint experience

Skills Claims Management: Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures. Legal Acumen: Familiarity with legal 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 legal professionals, policy holders and internal stakeholders. Information Analysis and Interpretation: Ability to critically evaluate reputed company medical records, policy language and legal arguments to reputed company informed decisions. Strong analytical and problem-solving skills. Maintain accurate records of reputed company cases in system of record. About reputed company At reputed company, we're a team committed to helping our clients secure their financial well-being so that they can pursue long and fulfilling lives. We turn challenges into opportunities by thinking, working, and leading differently - where everyone is a leader. We encourage every employee to reputed company their unique talents to become a force for good at reputed company and in their local communities. We are continuously investing in our people by offering growth, internal mobility, comprehensive compensation and benefits to support overall well-being, flexibility, and a culture of collaboration and teamwork. We are looking for talented, dedicated, purposeful people who want to reputed company an impact. Join reputed company and pursue a career with purpose. Click Careers at reputed company to learn more. reputed company is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national reputed company, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws. NOTE: reputed company participates in the E-Verify program. If reasonable accommodation is needed to participate in the job application or interview process or to reputed company the essential job functions of this position, please contact Human Resources at (212) 314-2211 or email us at TalentAcquisition@reputed company.com. Apply tot his job Apply To this Job