Sr Disability Appeals Consultant at Voya Financial

Minneapolis, Minnesota, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Financial Services, InsuranceIndustries

Requirements

5+ years of experience in insured and ASO disability claims and appeals processing
Strong understanding of Insured and ASO Group Disability policies, ERISA regulations and State disability and paid leave programs
Strong understanding of Deductible Sources of Income and how to independently calculate Group Disability or Statutory benefits
Excellent analytical, organizational, and verbal and written communication skills
Proficiency in claims management systems and Microsoft Office Suite
Ability to handle sensitive information with discretion and professionalism
Experience working with insurance carriers and third-party administrators
Familiarity with medical terminology and documentation
Conflict resolution and negotiation skills
Bachelor's degree (preferred)
Certification in Disability Management or Claims Handling (preferred)

Responsibilities

Review and analyze adverse claim determinations of disability or leave claims and appeal submissions
Investigate medical, financial, and administrative documentation to support appeal decisions
Ensure compliance with ERISA, Department of Labor, and other applicable regulations
Communicate comprehensive appeal outcomes clearly and professionally to claimants and stakeholders, verbally and in writing
Collaborate with internal or external medical consultants and legal teams as needed
Maintain accurate records of all appeal activities and correspondence
Provide mentorship and guidance to junior claims staff on appeals procedures
Stay current on regulatory changes and industry best practices

Skills

Disability Claims Adjudication

Appeals Management

ERISA Compliance

Federal Regulations

State Regulations

Short-Term Disability

Paid Family Leave

STD Benefits

Voya Financial

Provides financial services and retirement solutions

About Voya Financial

Voya Financial offers a range of financial services, including retirement plans, investment management, and insurance products, to help individuals and businesses achieve financial wellness. Their services cater to individuals seeking retirement planning, employers looking to enhance employee benefits, and institutions needing tailored investment management. Voya stands out from competitors through its commitment to inclusiveness and corporate responsibility, which helps attract clients and talent. The company's goal is to build long-term relationships with clients, ensuring they achieve financial confidence and a fulfilling life.

New York City, New YorkHeadquarters

2014Year Founded

IPOCompany Stage

Fintech, Financial ServicesIndustries

5,001-10,000Employees

Benefits

Health Savings Account (HSA)

Flexible Spending Accounts (FSA)

Rally wellness program

Employee Assistance Program (EAP) and Work Life Services

Behavioral Health Family Support Program

Livongo support for diabetes, hypertension, and weight management

AccessHope cancer support

Wellthy caregiving assistance

Back-up child care and elder care

Health Advocate

ABLE accounts

Legal insurance

Identity theft protection

Voya Foundation Matching Gift Program

Risks

Increased competition from fintech companies may erode Voya's market share.

Operational challenges in integrating OneAmerica's business could affect service quality.

Regulatory scrutiny on fees may impact Voya's pricing strategies and profitability.

Differentiation

Voya's commitment to inclusiveness and corporate responsibility sets it apart in the market.

The acquisition of OneAmerica's retirement plan business expands Voya's client base significantly.

Voya's focus on digital financial planning tools enhances client engagement and satisfaction.

Upsides

Voya's ESG commitment aligns with the growing investor focus on sustainable investing.

The financial wellness market's growth offers significant opportunities for Voya's programs.

AI integration in investment management can enhance Voya's strategies and client outcomes.

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