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Equitable · 2 weeks ago

Sr. Disability and Leave Management Claims Examiner- Group Insurance Claims Experience Required (REMOTE)

United States

Full-time

Remote

Mid, Senior Level

$60K/yr - $65K/yr

3+ years exp

Equitable is looking for an experienced Claims Specialist supporting Disability and Leave Management claims to join our team. The Claims Specialist is responsible for providing excellent customer service, utilizing judgment to assess risk, and working with various business partners to render claim decisions.

BankingConsultingFinancial Services

H1B Sponsor Likely

Responsibilities

Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved

Communication via telephone, email, and text with employees, employers, attorneys, and others

Review and interpret medical records, utilizing resources as appropriate

Complete financial calculations

Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication

Apply contract/policy provisions to ensure accurate eligibility and liability decisions

Demonstrate and apply analytical and critical thinking skills

Verify on-going liability and develop strategies for return-to-work opportunities as appropriate

Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication

Leverage a broad spectrum of resources, materials, and tools to render claims decisions

Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards

Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities

Work independently as well as within a team structure

Deliver refresher trainings as appropriate to the claim team

Identify areas for improvement in claims processing, including workflow changes or improving procedure based on trends or challenges observed in claim review

Prepare reports for management on claim outcomes and performance metrics

Assist in training and mentoring junior claim examiners on best practices, improving their decision-making skills

Oversee the ongoing management of complex, high-priority or escalated cases and callers

Qualification

Disability Claims AdministrationGroup Disability ClaimsDisabilityLeave LawsFineos Claim Management SystemAnalytical SkillsCustomer Service SkillsLeadership ExperienceCommunication SkillsOrganizational SkillsProblem SolvingTime ManagementConfidentialityFlexibilityTeam Collaboration

Required

Bachelor's degree or equivalent work experience

3+ disability claims administration experience

Prior leadership experience as a team lead or manager

Exceptional customer service skills

Maintains positive and effective interaction with challenging customers

Strong knowledge of disability and leave laws and regulations

Ability to handle sensitive information with confidentiality and professionalism

Group Disability Claims experience

Prior experience managing Paid Family Leave for multiple state

Preferred

Experience working with the Fineos Claim Management System

Exceptional written and oral communication skills demonstrated in previous work experience

Excellent organizational and time management skills with ability to multitask and prioritize deadlines

Ability to manage multiple and changing priorities

Detail oriented; able to analyze and research contract information

Demonstrated ability to operate with a sense of urgency

Experience in effectively meeting/ exceeding individual professional expectations and team goals

Demonstrated analytical and math skills

Ability to exercise critical thinking skills, risk management skills and sound judgment

Ability to adapt, problem solve quickly and communicate effective solutions

High level of flexibility to adapt to the changing needs of the organization

Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment

Continuous improvement mindset

A commitment to support a work environment that fosters diversity and inclusion

Proficiency in computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word

Benefits

Medical

Dental

Vision

A 401(k) plan

Paid time off

Company

Equitable

Glassdoor3.6

Equitable provides consulting services to secure the financial well-being and retirement strategies for individuals and families.

Founded in 1859

New York, New York, USA

5001-10000 employees

https://equitable.com/

H1B Sponsorship

Equitable has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2025 (31)

2024 (18)

2023 (26)

2022 (37)

2021 (20)

2020 (12)