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
Senior Specialist • Milwaukee, Wisconsin, United States