Senior Appeals Specialist

Job Summary

A company is looking for a Sr. Appeals Specialist.

Key Responsibilities

• Review and develop action plans for appealed claims according to policy provisions
• Resolve appeals in a timely manner and communicate outcomes to relevant parties
• Collaborate with Compliance to manage complaints and maintain accurate recordkeeping

Required Qualifications

• Knowledge of ERISA, HIPAA, and relevant insurance laws
• Strong understanding of Short-Term Disability, Long Term Disability, and Life claims processing
• Experience with specialty reviews and litigated claim matters
• Proficiency in Microsoft Office and related software
• High School Diploma required