Appeals Specialist
Appeals Specialist
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
Position Title: Appeals Specialist
Reports To: Manager Life STD LTD Claims
Department: Group
Term: Permanent Full-Time
Work Arrangements: This is a hybrid role. You will work in our office in Waterloo ON a minimum of two (2) assigned consecutive days every other week plus a fifth (5th) assigned day per month. You are welcome to work from the office more than the minimum requirement and there may be some roles that are required to work in our office more than the minimum requirement.
The Opportunity:Equitable is growing! We are looking for a Appeals Specialist to join our Group Claims Team! This team member will be responsible for assessing short- and long-term disability claims where the decision to terminate benefits has been appealed by the plan member. Now is an exciting time to join one of the Waterloo Areas Top Employer for 2025 and Southwestern Ontarios Top Employers for 2024!
What you will be doing:
- Analyze medical functional employment and contractual information in order to make timely and accurate decisions on appealed STD and LTD claims
- Provide coaching support to the Disability Claims Specialist (DCS) to ensure all necessary information and action has been taken on each file
- Frequently communicate with plan sponsors plan members advisors and other professionals as required
- Track and monitor appeals data; assist in setting appropriate targets to measure effectiveness of progress and success
- Assist in developing the best practice resources related to the appeals process
- Collaborate with the best practice team and claims managers to identify trends and opportunities for improvement; assist leadership team with coaching and claim reviews as required
- Handle all access requests within required timelines
- Assist Senior Litigation Consultant with subrogation and file preparation for litigated files as required
What you will bring:
- Superior case management and problem solving/decision making skills
- Demonstration of our Service First Principles (empathy demonstrate expertise easy to do business with take ownership treat everyone fairly)
- Exceptional written communication skills to help shape letter writing practices
- Ability to deliver constructive feedback in a tactful and effective way
- Strong knowledge of group disability insurance and policy provisions
- Process improvement mindset
- Comfort with ambiguity and desire to shape new practices and processes
- Flexibility to assist team where required
- Ability to proactively manage a fluctuation and unpredictable workload
Whats in it for you:
- A healthy work-life balance with employee wellness top of mind
- Annual bonus program annual vacation allowance and company-paid benefits program
- An additional paid volunteer day each year so you can spend time giving back to the community
- Immediate enrollment in the companys pension program with employer matching
- Employee resource groups that support an inclusive work environment
- Tuition support and specialized program assistance
- An onsite full-service cafeteria with a variety of daily options
- Discounts on company products and services and access to exclusive employee perks
- Regular EQ Together events focused on company togetherness and collaboration
As part of the recruitment/offer process you will be required to:
- Provide two professional references (minimum one supervisor and above)
This role is open due to an existing vacancy.
To learn more about Equitable we encourage you to explore our organization.
At Equitable we are committed to providing equal access to employment opportunities across our organization. Please contact our HR team at emailprotected if you would like to receive our job postings in an alternative format or require an accommodation with the application process.
#LI-Hybrid
Other details
- Job FamilyIndividual Contributor - Non Transactional
- Pay TypeSalary
Required Experience:
Unclear Seniority
Employment Type
Full-Time
