Senior Disability Appeals Consultant

A company is looking for a Sr Disability Appeals Consultant responsible for managing and adjudicating appeals related to adverse claim determinations of disability and leave benefits.

Key Responsibilities

Review and analyze adverse claim determinations and appeal submissions

Investigate medical, financial, and administrative documentation to support appeal decisions

Ensure compliance with ERISA and other applicable regulations while communicating appeal outcomes to stakeholders

Required Qualifications

5+ years of experience in insured and ASO disability claims and appeals processing

Strong understanding of Insured and ASO Group Disability policies and ERISA regulations

Proficiency in claims management systems and Microsoft Office Suite

Experience working with insurance carriers and third-party administrators

Bachelor's degree or certification in Disability Management or Claims Handling is preferred