Disability and Leave Management Claims Specialist

This is a fully remote position, open to applicants in New York, +1 more state.

📋 Description

• Provide an outstanding customer experience while ensuring that commitments and deliverables to customers are met.

• Engage in communication through phone, email, and text with employees, employers, attorneys, and other stakeholders.

• Analyze and interpret medical records, utilizing relevant resources as necessary.

• Perform financial calculations with precision.

• Acquire a comprehensive understanding of the Equitable claim system and other relevant policies, procedures, contracts, as well as the regulatory and statutory requirements for claim adjudication.

• Apply contract and policy provisions to ensure accurate decisions regarding eligibility and liability.

• Exhibit and utilize analytical and critical thinking abilities.

• Validate ongoing liability and formulate strategies for return-to-work opportunities as needed.

• Record objective, clear, and technical reasoning for all claim decisions, demonstrating the capability to effectively convey claim outcomes to customers through both oral and written communication.

• Utilize a diverse range of resources, materials, and tools to make informed claims decisions.

• Ensure a timely and exceptional customer experience by accurately processing claims promptly, addressing all inquiries, and upholding expected service and quality standards.

• Operate effectively in a high-paced environment with strict deadlines, showcasing the ability to manage multiple priorities.

• Function independently as well as collaboratively within a team setting.

⛳️ Requirements

• A Bachelor’s degree or equivalent professional experience is required.

• Minimum of 1 year of experience in disability claims.

• Outstanding customer service abilities.

• Ability to maintain positive and effective interactions with challenging customers.

• Strong understanding of disability and leave laws and regulations.

• Capability to manage sensitive information with confidentiality and professionalism.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• 401(k) plan.

• Paid time off.