STD Claims Appeals Specialist

Job Summary

Working remotely, the full-time STD Claims Appeals Specialist will manage a caseload of Short-Term Disability appeals, conducting reviews and analyses while interpreting contract terms and ERISA requirements to ensure fair claim determinations.

Key responsibilities

• Analyze and process claims by investigating complex information and applying relevant policies and procedures
• Interpret complex coverage contracts to determine eligibility and resolve financial calculation gaps
• Provide technical guidance to Claims management and teams regarding claims processes and applicable regulations

Required qualifications

• 4 Year/Bachelor's degree or equivalent work experience (4 years of experience in lieu of Bachelor's)
• 3+ years of claims and/or appeals experience with LTD/STD claims
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
• Experience working with multiple products is a plus
• Presentation training or skills are desirable