Quality Review Specialist Disability Claims
Quality Review Specialist Disability Claims
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
At Equitable our power is in our people. Were individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here youll work with dynamic individuals build your skills and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential
Equitable is seeking detailoriented and experienced Quality Review Specialist to join our Disability and Paid Leave Claims organization. The Quality Review Specialist is responsible for the equality review of Short Term Disability and Paid Leave claim processing. Ideal candidates will have a creative mindset for developing and operating a Quality Program with a lens on the customer experience.
Key Job Responsibilities
- Quality Assurance:
- Conduct thorough reviews of Paid Leave and Short Term Disability claims to ensure compliance with internal state and regulatory requirements.
- Share feedback with a coaching mindset with a focus on talent development and continuous improvement.
- Conduct thorough reviews of Paid Leave and Short Term Disability claims to ensure compliance with internal state and regulatory requirements.
- Process Improvement:
- Collaborate with crossfunctional teams to identify opportunities for improvement in current processes.
- Stay updated on changes in insurance regulations and industry best practices.
- Partner with teams to develop innovative solutions to elevate outcomes and customer experience.
- Collaborate with crossfunctional teams to identify opportunities for improvement in current processes.
- Program Development:
- Assist in establishing and building a comprehensive quality program tailored to the needs of our organization.
- Assist in establishing and building a comprehensive quality program tailored to the needs of our organization.
- Technical Expertise:
- Apply technical knowledge to evaluate and enhance the effectiveness of Short Term Disability and Paid Leave programs.
- Apply technical knowledge to evaluate and enhance the effectiveness of Short Term Disability and Paid Leave programs.
- Data Analysis:
- Analyze data and generate reports to track performance metrics and identify emerging trends or opportunities.
- Analyze data and generate reports to track performance metrics and identify emerging trends or opportunities.
The base salary range for this position is $50000 $65000. Actual base salaries vary based on skills experience and geographical location. In addition to base pay Equitable provides compensation to reward performance with base salary increases spot bonuses and shortterm incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees Equitable provides a full range of benefits. This includes medical dental vision a 401(k) plan and paid time off. For detailed descriptions of these benefits please reference the link below.
Equitable Pay and Benefits: Equitable Total Rewards Program
Required Qualifications
- 3 years of experience in the insurance industry
- Professional work experience with Group Insurance Short Term Disability and Paid/Unpaid Leaves claims management
Preferred Qualifications
- Prior experience with Group Insurance Claims Quality Review is beneficial
- Strong analytical skills with excellent attention to detail
- Experience with Intake and Onboarding functions is a plus
- Strong verbal written communication and presentation skills
- Ability to think creatively and propose innovative solutions for Quality Program development and continuous improvement
- Comfortable dealing with complexity and ambiguity and able to explore multiple solutions
- Previous experience with FINEOS Claims software platform
Skills
Claims Management: Comprehensive understanding of insurance policies coverage terms medical classification and claims adjudication procedures.
Effective Communications: Excellent written and verbal communication to effectively convey information to diverse audiences including legal professionals policy holders and internal stakeholders.
Information Analysis and Interpretation: Ability to critically evaluate complex medical records policy language to make informed insight on claims management and strategy. Strong analytical and problemsolving skills. Maintain accurate records of all cases in system of record.
ABOUT EQUITABLE
At Equitable were a team committed to helping our clients secure their financial wellbeing so that they can pursue long and fulfilling lives.
We turn challenges into opportunities by thinking working and leading differently where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth internal mobility comprehensive compensation and benefits to support overall wellbeing flexibility and a culture of collaboration and teamwork.
We are looking for talented dedicated purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
**********
Equitable is committed to providing equal employment opportunities to our employees applicants and candidates based on individual qualifications without regard to race color religion gender gender identity and expression age national origin mental or physical disabilities sexual orientation veteran status genetic information or any other class protected by federal state and local laws.
NOTE: Equitable participates in the EVerify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position please contact Human Resources ator email us at.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
