Associate - Operations (Appeal Support Specialist)

Responsibilities

• Provide clear and comprehensive communication to insureds, plan holders, attorneys, and others by phone, e-mail and mail with respect to issues in dispute.
• Work and data will accurately be added and monitored in the Appeal Log and/or similar tracking tools for reporting purposes.
• Incoming correspondence will be monitored through Mailbox and portal platforms to add or upload to the associated claim. Tasking will be set as needed to alert its assigned Appeal Specialist or Case Manager etc.
• Will take lead role in the preparation, build, and completion of various file copies or Grievance file needs based on the specific Client need and processes.
• Meet or exceed Department Goals and Objectives including strong teamwork initiatives.
• Comply with state and federal regulations, department procedures and compliance directives.
• Provide appropriate feedback to help assess the training needs of the organization and participate in ongoing training and development offerings to enhance administration skills.
• Eligibility & Knowledge
• Graduate in listed discipline BA, B.Com, BCA ( No Gaps / Failure throughout Graduation)
• Overall, 2 and above years of work experience with LOA claims or support function within an insurance/ financial organization
• Ability to work evening/night shifts
• Data analysis and reporting proficiency
• Excellent written and verbal communication
• Intermediate knowledge of Microsoft Office, including Outlook, SmartSheets, Teams, Excel and Word.
• Prior experience with disability products (STD/LTD), Leave programs, ERISA regulations, and medical terminology would be beneficial, to include knowledge of TPA operations.
• Basic knowledge of state and federal compliance issues impacting claim administration and appeals.
• Demonstration of good judgment, professionalism, and the ability to handle confidential information.
• Well organized, able to multi-task and identify priorities.

Benefits

Additional Information

Our story At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight." Our Values: Champion People - be empathetic and help create a place where everyone belongs. Grow with purpose - Be inspired by our higher calling of improving lives. Be Alight - act with integrity, be real and empower others. It's why we're so driven to connect passion with purpose. Our team's expertise in human insights and cloud technology gives companies and employees around the world the ability to power confident decisions, for life. With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work. Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight. Learn more at careers.alight.com. (THE ROLE) The Appeals Support Specialist will provide administrative support and guidance to both the Appeal and Claims departments regarding disability and leaves administration through Third Party Administration services. This position will research each new appeal receipt to verify acceptance and assignment to the Appeal Specialists. Each receipt will be logged and assigned based on department guidelines and Client needs. Acknowledgement and general correspondence will be sent as needed, and future tasking established and set within multiple Claims payment systems. Additional duties will include the submission and monitoring of vendor-related services and the timely uploading of documents into the associated claim. File copy builds will also be a routine function within this role as well as the management of multiple mailbox systems. This role is clerical in nature requiring strong attention to detail and the ability to multi-task several Client and department processes for accuracy. May also assist with team projects and audits as necessary.

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