Senior Appeals Specialist

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