[Remote] Disability Claims Appeal & Complaints Analyst (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 a Disability Claims Appeal & Complaints Analyst responsible for managing and resolving complex insurance claims disputes, investigating appeals, and ensuring compliance with regulatory standards and company policies.

Responsibilities
• Analyst will handle appeals submitted on Disability (STD, LTD, Leave) products
• Review adverse claim life decisions within STD, LTD, State Leave product line
• Review claim files in depth and detail to determine if previous claim decision (adverse claim decision) was appropriate or if prior decision should be reversed
• Provide high level feedback on claim handling
• Handle appeals in line with job aids in place
• Responsible for reviewing regulatory & presidential complaints and providing responses to appropriate agency

Skills
• Prior claim handling experience in fully and self-insured STD, LTD and State Leave lines of business
• Prior Appeal handling experience in fully/self insured STD, LTD, State Leave lines of business including decision letter writing
• Prior Complaint handling experience (regulatory, Sr. Officer, Presidential)
• Contract review and interpretation
• Letter writing skills
• Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures
• Familiarity with legal principles relevant to insurance disputes, including contract law, civil procedure, and regulatory requirements
• Excellent written and verbal communication to effectively convey information to diverse audiences including legal professionals, policy holders and internal stakeholders
• Ability to critically evaluate complex medical records, policy language and legal arguments to make informed decisions
• Strong analytical and problem-solving skills
• Maintain accurate records of all cases in system of record
• FINEOS experience is preferred
• Microsoft office products
• Excel experience/knowledge
• PowerPoint experience

Benefits
• Medical
• Dental
• Vision
• A 401(k) plan
• Paid time off

Company Overview
• Equitable provides consulting services to secure the financial well-being and retirement strategies for individuals and families. It was founded in 1859, and is headquartered in New York, New York, USA, with a workforce of 5001-10000 employees. Its website is https://equitable.com/.

Company H1B Sponsorship
• Equitable has a track record of offering H1B sponsorships, with 31 in 2025, 18 in 2024, 26 in 2023, 37 in 2022, 20 in 2021, 12 in 2020. Please note that this does not guarantee sponsorship for this specific role.

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