Senior Appeals Analyst
$66,700–$110,100 year
On-siteNewark, New Jersey, United States
Job Summary
Manage and assigned caseload of disability appeals by utilizing internal and external clinical, vocational, and legal experts to administer contractual provisions. Demonstrate industry-leading customer service while exercising sound judgment to develop differentiated appeals plans that lead to optimal outcomes. Provide direct feedback on claim handling and identify opportunities for improved claim management across the organization. Apply expertise in ERISA, non-ERISA, and state-specific disability requirements to resolve complex cases. Work independently in a fast-paced environment to balance workflow and partner interdepartmentally to support continuous improvement and training initiatives.
Required Qualifications
- 3-5 years of experience in stand-alone Short and/or Long-Term Disability claims
- Working knowledge of ERISA appeal requirements
- Working knowledge of non-ERISA appeal considerations
- Working knowledge of state-specific disability requirements
- Demonstrated superior customer service skills
- Excellent written and verbal communication skills
- Strong analytical and critical thinking skills
- Ability to work independently
- Ability to manage difficult interactions to resolution
- Proficiency with claim systems
- Proficiency with Microsoft Office applications
- Proficiency with documentation tools used to research, evaluate, and record claim and appeal activity
Desired Qualifications
- Disability Appeals experience
- College Degree
- Aptitude to learn and integrate new technology into workflow
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