Supervisor, Disabilty Risk Appeals

Responsible for supervising STD/LTD, Dental, LIFE, AD&D and Life Waiver appeals staff to ensure complainants receive a full, fair and timely review of appealed adverse determinations. Develops staff by leading, monitoring, coaching, and training. Conveys management goals and directions to staff. Assists Risk Manager in creating vision and affecting change. Communicates and interfaces with all levels of management on behalf of the Appeals Team and secures organizational cooperation for needed changes. Recruits, interviews and hires Life and Disability Appeals Specialists. Builds trust and inspires teamwork to encourage skill building and risk taking.

• Manages performance of the Appeals Specialists
• Responsible for daily work management to ensure service standards are met and/or exceeded
• Voting member of Appeals Council
• Approves & tracks sick, vacation and overtime
• Accountable for making financial decisions related to appeals
• Coordinates with Proficiency Staff to analyze quality trends and identify training opportunities
• Develops internal processes and procedures
• Oversees execution of new results strategies
• Actively leads complex projects as directed
• Responsible for diffusing escalated broker/RGO inquires
• Research and respond to presidential complaints
• Develop Sr. Disability Specialist as a supervisor back-up
• Coach and develop team based upon employee skill-set
• Serve as the department liaison with Legal and Compliance
• Create, run and reconcile reports for Appeals
• Leads by example
• Assumes Risk Manager responsibilities when needed

• College degree or equivalent work experience
• Five plus years disability, life and dental insurance work experience
• Proven record of success in effective risk management
• Formal leadership training and/or supervisory experience
• Strong knowledge of IBM software programs, including, but not limited to: word processing software, spreadsheet software and e-mail
• Experienced with ad hoc reporting software is required
• Completion of Group HIAA, LOMA, ICA and other industry courses is desirable
• Exemplary written and verbal communication skills
• Ability to use logic, accuracy and strict attention to detail are mandatory
• Must possess excellent analytical, problem solving and communication skills
• Prior mentoring experience is necessary
• Unquestionable ethics and integrity