Employee Benefits Claims Consultant (Group Insurance Claims Experience Required)

Equitable; United States; Remote; USD 75,000 - 90,000; Full time

Job summary

Equitable is seeking a Claims Resource to oversee the claims Third Party Administrator vendor relationship, ensuring quality service delivery. The ideal candidate will have experience in insurance claims, data analysis, and a commitment to exceptional customer service. Join a company dedicated to unlocking your potential and fostering collaboration.

Benefits

401(k) plan

Medical, dental, and vision coverage

Paid time off

Spot bonuses and short-term incentives

Qualifications

• 3+ years of experience with group insurance claims.
• Experience creating, analyzing, and refining dashboards and reporting.
• Strong verbal and written communication skills.

Responsibilities

• Oversees the end-to-end claims process for multiple products.
• Fosters strong relationships with TPA partner, brokers, and clients.
• Ensures compliance with relevant laws and regulations.

Skills

Effective Communication

Problem-Solving Skills

Adaptability

Attention to Detail

Customer Service Orientation

Job description

At Equitable, our power is in our people. We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?

Equitable is seeking a dynamic resource to join our Employee Benefits Claims organization. This role will play a critical part in overseeing our claims Third Party Administrator (TPA) vendor relationship, fostering collaboration, and ensuring exceptional service delivery for claimants, clients, and brokers.

Key Job Responsibilities

• Claims Knowledge: Oversees the end-to-end claims process for multiple products. Ensures claims are processed within regulatory and company guidelines. Creates and monitors reporting to ensure timeliness, accuracy, and quality.
• Stakeholder Relationships: Fosters strong relationships with our TPA partner, brokers, and clients to understand their needs and ensure high levels of satisfaction. Helps address and resolve any customer issues or concerns promptly.
• Data Analysis and Interpretation: Advanced proficiency in claims data analysis techniques and tools. Ability to interpret complex data sets to make informed decisions and drive continuous improvement initiatives. Skilled in using data to identify trends, root causes, and opportunities for enhanced processes.
• Compliance: Ensures all claims processes comply with relevant laws and regulations, leverage internal and external sources. Stays current regarding updated changes in legislation and adjusts processes accordingly.
• Collaboration: Partners with internal departments, external partners, and other key stakeholders to execute a market-leading claims experience.
• Performs other duties as assigned.

The base salary range for this position is $75,000 - $90,000. 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 link below.

Equitable Pay and Benefits : Equitable Total Rewards Program

Required Qualifications

• 3+ years of experience with group -insurance claims
• Experience creating, analyzing, and refining dashboards and reporting
• Strong verbal and written communication skills

Preferred Qualifications

• Strong understanding of technology and industry trends
• Excellent client relationship management skills
• Strong presentation skills
• Comfortable dealing with complexity and ambiguity and able to explore multiple solution

Skills

Effective Communication: Proficient in effective communication concepts, tools, and techniques. Capable of transmitting, receiving, and accurately interpreting ideas, information, and needs through the application of appropriate communication behaviors.

Problem-Solving Skills: Demonstrates an ability to identify issues within the claims process and develop effective solutions promptly. Uses analytical thinking to assess situations accurately and implement strategies that enhance efficiency and service quality.

Adaptability: Adapts to changing circumstances, such as shifts in regulations or internal processes. Adaptability ensures that the team can maintain high performance and service standards even in dynamic situations.

Attention to Detail: Ensures accuracy in claims processing and reporting. Attention to detail helps in identifying discrepancies or errors in documentation, which is crucial for maintaining compliance and service quality.

Customer Service Orientation: A strong focus on customer service is important for addressing the needs of clients, claimants, and brokers effectively. This skill involves empathy, patience, and the ability to provide clear and helpful responses to inquiries or concerns.

ABOUT EQUITABLE

At Equitable, we’re a team of over ten thousand strong; 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 support overall well-being, flexibility, and a culture of collaboration and teamwork.

We are looking for talented, dedicated, purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.

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Equitable is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national origin, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws.

NOTE: Equitable participates in the E-Verify program.

If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position, please contact Human Resources at [phone] or email us [e-mail] .