Disability Appeals Specialist

Job Summary

A company is looking for a Disability Appeals Specialist to review adverse determinations for Short-Term and Long-Term Disability claims.

Key Responsibilities

• Manage the investigation of disputed Short-Term Disability (STD) and Long-Term Disability (LTD) claims through the appeals process
• Assess medical, financial, and non-medical information to resolve disputed claims
• Provide comprehensive communication with insured individuals, plan holders, and other parties regarding claim-related issues

Required Qualifications

• High school diploma or equivalent; Bachelor's degree preferred
• At least three years of experience with STD/LTD claims and product management
• In-depth understanding of state and federal compliance issues related to claims and appeals, including ERISA
• Familiarity with medical terminology and conditions
• Proficiency with Microsoft Office, especially Outlook and Word