[Remote] Disability and Leave Management Claims Specialist (Disability Claims Experience Required) (REMOTE)

Note: The job is a remote job and is open to candidates in USA. Equitable is a company dedicated to helping clients secure their financial well-being. They are seeking an experienced Claims Specialist to support Disability and Leave Management claims, focusing on providing exceptional customer service and making informed claim decisions.

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

Skills

• Bachelor's degree or equivalent work experience
• 1+ years disability claims experience
• 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
• 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 Overview