Appeals Specialist-Alight Leave Solutions

Alight, Inc.

Job Overview

Location

US-IL-Illinois-Virtual

Job Type

Full-time

Full Job Description

📋 Description

• We are seeking an Appeals Specialist to join our team at Alight, Inc. in the US.
• As an Appeals Specialist, you will review adverse determination outcomes for Short Term Disability and Long-Term Disability claims, ensuring compliance with regulatory requirements and making fair, thorough, and timely appeal determinations.
• You will be responsible for investigating STD and LTD claims that are in dispute, effectively tracking and managing assigned case loads of claim appeals, and providing clear communication to insureds, plan holders, attorneys, and others with respect to issues in dispute.
• You will also interpret policy provisions, state and federal regulations, department procedures, and compliance directives, and mentor Specialists and provide guidance on the interpretation and administration of contract language.
• We are looking for an individual with experience in STD/LTD product and claims management knowledge, state and federal compliance issues impacting claim administration and appeals, ERISA compliance claim review, and medical knowledge.
• You will also be required to demonstrate good judgment, professionalism, and the ability to handle confidential information, and possess a High School diploma or commensurate level of education.
• We offer a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

🎯 Requirements

• Have experience of three or more years in STD/LTD product and claims management knowledge.
• Have experience in state and federal compliance issues impacting claim administration and appeals.
• Have experience with ERISA compliance claim review.
• Have work experience with medical knowledge (i.e., medical terminology, medical conditions).
• Demonstrate good judgment, professionalism, and the ability to handle confidential information.
• Possess High School diploma or commensurate level of education required. (Bachelor’s degree preferred).

🏖️ Benefits

• Competitive total rewards package.
• Continuing education & training.
• Tremendous potential with a growing worldwide organization.

Skills & Technologies

Angular

Remote

Degree Required

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Alight, Inc.

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About Alight, Inc.

Alight, Inc. is a leading cloud-based provider of integrated benefits solutions. The company offers a comprehensive suite of services designed to help employers manage their employee benefits programs effectively. These services include health and wellbeing solutions, retirement plan administration, payroll services, and financial wellbeing tools. Alight focuses on leveraging data and technology to personalize employee experiences, improve health outcomes, and drive financial security for individuals and their families. They serve a diverse range of clients, from small businesses to large enterprises, aiming to simplify complex benefits landscapes and empower employees to make informed decisions about their health, wealth, and wellbeing.

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