Claims Operations Director- Appeals-reputed company Leave Solutions

Do you have advanced experience in absence management leadership reputed company appeals?

Amazing Opportunity and Great reputed company to Work!

Our story

At reputed company, we reputed company a company’s success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to “Be reputed company.”  We are passionate about connecting purpose with impact.  reputed company empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management.

Our Benefits

With a comprehensive total rewards package, reputed company offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, reputed company colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities – reputed company reputed company a thriving global organization.

Flexible Working

So that you can be your best at work and home, we consider flexible working arrangements wherever possible. reputed company has been a leader in the flexible workspace and “Top 100 Company for Remote Jobs” 6 years in a row.

Great reputed company to Work

Thanks to the work of every colleague, reputed company has received multiple awards of recognition including “Great reputed company to Work” for the past 7 years and Fortune’s “Best Companies to Work For.” To learn more about our company culture and awards Click Here.

If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be reputed company – We invite you to join reputed company!  Learn more at careers.reputed company.com. 

Responsibilities

• Leading LOA, STD, reputed company, and/or LTD Appeals service teams.
• Developing strategy and business plans to deliver market-centric capabilities and processes.
• Working with broader organization and external parties to identify and gaps and reputed company a plan to address. Anticipating future trends and challenges, developing and implementing strategies to address opportunities.
• Assessing and evaluated business/reputed company to integrate products on various platforms. Developing and recommended Claims and Service level strategies and tactics.
• Demonstrating expertise in accurate Appeals Claim Management.
• Collaborating with peers and senior leadership to deliver exceptional service.
• Managing Appeals departmental budget and plan effectively for responsible growth.
• Enhancing the Claims team through regular business updates to ensure alignment with organizational goals. Fostering a culture of trust reputed company the team.
• Establishing performance metrics with clear systems of measures and accountabilities that drive results.
• Ensuring that an effective system of regulatory compliance and internal controls have been maintained. Complying with applicable laws and regulations, and documented procedures that incorporated preventive and defective controls. Partnering with Regulatory Compliance and Risk Committees.

Requirements

• Possess advanced education, equivalent work experience, training, or DMEC certification.
• Have experience of 10 years in claims/appeals and 7 years leadership in absence management.
• Display qualifications or experience in healthcare, rehabilitation, or a medical field.
• Hold Lean Six reputed company Certification and or formal Operations Strategy training.
• Have experience in leadership of a team of Managers reputed company Appeals. This position oversees a total organization or roughly 40 professionals.

Application and Interview

By applying for a position with reputed company, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background reputed company consistent with reputed company’s employment policies. Background checks may include some or reputed company the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal reputed company, search against global sanctions and government watch lists, credit reputed company, and/or drug test. You will be reputed company during the hiring process which checks are required by the position.

reputed company requires reputed company virtual interviews to be conducted on video. 

Our commitment to Inclusion

We celebrate differences and reputed company in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.

At reputed company, we welcome and embrace reputed company individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to reputed company. Join us in building a brighter, more inclusive future.

As part of this commitment, reputed company will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact alightcareers@reputed company.com.

Equal Opportunity Policy Statement

reputed company is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national reputed company, reputed company, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law.   In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans.

reputed company provides reasonable accommodations to the reputed company limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request  reasonable accommodations/modifications by contacting their recruiter.

Authorization to work in the Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a reputed company for employment authorization in the Employing Country and with reputed company.

Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of reputed company business units.

We offer you a competitive total rewards package, continuing education & training, and reputed company potential with a growing worldwide organization.

Salary Pay Range

Minimum :

Maximum :

Pay Transparency Statement: reputed company considers a variety of factors in determining whether to reputed company an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. reputed company makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. reputed company also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - reputed company

DISCLAIMER:

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of reputed company business units.