Disability Claims Appeal & Complaints Analyst; REMOTE

Disability Claims Appeal & Complaints Analyst (REMOTE) Primary Location

UNITED STATES-Remote

UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse

Equitable

Full-time

At Equitable, we help clients secure their financial well‑being so they can pursue long and fulfilling lives- a mission we’ve honed since 1859.

Equitable is seeking an influential and dynamic Disability Claims Appeal & Complaints Analyst to join our Disability and Absence Claims organization. The Disability Claims Appeal & Complaints Analyst is responsible for managing and resolving complex insurance claims disputes. This role involves investigating appeals, preparing applicable legal documentation, and ensuring compliance with regulatory standards and company policies. The Analyst will act as a liaison between the claims department, legal counsel, and policyholders as necessary.

• 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.

This position offers a remote work schedule that allows you to stay fully engaged with your team to provide outstanding, customer‑focused service during our core hours (8:30 AM–5:30 PM EST). Periodic office visits may be requested based on business needs.

The base salary range for this position is $50,000 - $65,000. 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 short-term 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 following link:
Equitable Total Rewards Program.

• 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.

• FINEOS experience is preferred
• Microsoft office products
• Excel experience/knowledge
• PowerPoint experience

Claims Management: Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures.

Legal Acumen: Familiarity with legal principles relevant to insurance disputes, including contract law, civil procedure, and regulatory requirements.

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 and legal arguments to make informed decisions. Strong analytical and problem‑solving skills. Maintain accurate records of all cases in system of record.

#LI-Remote

At Equitable, we’re a team committed to helping our clients secure their financial well‑being 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…