Specialist, Appeals Claims (Short-Term Disability)

Lincoln Financial; Carson City (NV); Hybrid; USD 53,000 - 97,000; Full time

Job summary

A leading financial services provider is seeking an Appeals Specialist. This hybrid role requires analyzing and processing complex claims, communicating effectively with stakeholders, and providing technical guidance. The ideal candidate will have a degree or equivalent experience and proficiency in Microsoft Office. Compensation ranges from $53,500 to $96,300, with additional benefits including leadership training and financial counseling.

Benefits

Leadership development opportunities

PTO/parental leave

Competitive 401K and employee benefits

Tuition assistance program

Free financial counseling

Qualifications

• 1 - 3+ Years of Short-Term and/or Long-Term Disability required.
• Ability to analyze complex coverage contracts.
• Experience in claims processing and litigation.

Responsibilities

• Analyze & process claims by investigating complex information.
• Determine eligibility by interpreting insurance coverage contracts.
• Provide technical information on claims processes to stakeholders.

Skills

Effective verbal communication

Effective written communication

Proficiency in Microsoft Office Suite

Education

4 Year/Bachelor's degree or equivalent work experience

Tools

Microsoft Office Suite

Job description

Alternate Locations

Work from Home; Charlotte, NC (North Carolina); Omaha, NE (Nebraska); US All Regions

Work Arrangement

Hybrid : Employee will work 3 days a week in a Lincoln office

Relocation assistance

is not available for this opportunity.

Requisition #

74565

The Role at a Glance

As an Appeals Specialist you will be responsible for being a product subject matter expert to provide full, fair appeal reviews for multiple product lines. You will perform and deliver on appeals claims assignments/projects while simultaneously leveraging and applying knowledge. You will analyze and manage a caseload of appeals claims. You will review, investigate, and make claim determinations regarding coverage, compensability, and appropriateness of claims. You will provide technical information and detailed guidance to Claims management & teams regarding products, claims processes, regulations, and applicable systems for their assigned claims area. If this sounds like a role for you, please read on!

What you\'ll be doing

• Analyze & process claims by investigating & obtaining a wide range of complex information. Apply claim policies & procedures and engages intervention of internal/external resources to ensure fair, ethical, & timely management of assigned claims.
• Analyze and interpret complex coverage contracts to determine if eligibility is met.
• Identify, interpret, and resolve gaps in financial calculations and offsets when applicable, share technical knowledge and approach on financial calculations with team members that involve complex contract provisions.
• Research questions and escalations from Claims team; liaises with various stakeholders from across the business (Underwriting, Actuarial, Compliance, Account Management, etc.) to obtain needed information to clarify and address issues.
• Provide customers with in-depth explanations of policy details, claim process, and claim determination; ensure parties understand the information and outcome.
• Utilize internal reporting to identify trends and review/audit performance against team metrics; propose and develop practices & processes to improve performance and the customer experience.
• Effectively utilize and implement policies & procedures regarding medical terminology, duration, functionality documentation, and overall claims workflow. Provide detailed guidance & coaching to junior team members.

What we\'re looking for

Must-have:

• 4 Year/Bachelor\'s degree or equivalent work experience (4 years of experience in lieu of Bachelor\'s)
• 1 - 3+ Years of Short-Term and/or Long-Term Disability. (Required)
• Ability to communicate effectively (verbal/written)
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)

Nice-to have:

• Experience working with multiple products.
• Presentation training or skills
• Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.
• SystemOne experience

Application Deadline

Applications for this position will be accepted through 10/24/2025 subject to earlier closure due to applicant volume.

What\u2019s it like to work here?

At Lincoln Financial, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.

What\u2019s in it for you:

• Clearly defined career tracks and job levels, along with associated behaviors for each of Lincoln\'s core values and leadership attributes
• Leadership development and virtual training opportunities
• PTO/parental leave
• Competitive 401K and employee benefits (https://www.lincolnfinancial.com/public/aboutus/careers/lifeatlincoln#benefits)
• Free financial counseling, health coaching and employee assistance program
• Tuition assistance program
• Work arrangements that work for you
• Effective productivity/technology tools and training

The pay range for this position is $53,500 - $96,300 with anticipated pay for new hires between the minimum and midpoint of the range and could vary above and below the listed range as permitted by applicable law. Pay is based on non-discriminatory factors including but not limited to work experience, education, location, licensure requirements, proficiency and qualifications required for the role. The base pay is just one component of Lincoln’s total rewards package for employees. In addition, the role may be eligible for the Annual Incentive Program, which is discretionary and based on the performance of the company, business unit and individual. Other rewards may include long-term incentives, sales incentives and Lincoln’s standard benefits package.

About The Company

Lincoln Financial (NYSE: LNC) helps people to confidently plan for their version of a successful future. We focus on identifying a clear path to financial security, with products including annuities, life insurance, group protection, and retirement plan services.

With our 120-year track record of expertise and integrity, millions of customers trust our solutions and service to help put their goals in reach.

Lincoln Financial Distributors, a broker-dealer, is the wholesale distribution organization of Lincoln Financial. Lincoln Financial is the marketing name for Lincoln Financial Corporation and its affiliates including The Lincoln National Life Insurance Company, Fort Wayne, IN, and Lincoln Life & Annuity Company of New York, Syracuse, NY. Lincoln Financial affiliates, their distributors, and their respective employees, representatives and/or insurance agents do not provide tax, accounting or legal advice.

Lincoln is committed to creating a diverse and inclusive environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Be Aware of Fraudulent Recruiting Activities

If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.

Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln\'s fraud team at [e-mail] if you encounter a recruiter or see a job opportunity that seems suspicious.

Additional Information

This position may be subject to Lincoln\u2019s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln\u2019s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.

Any unsolicited resumes or candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial are considered property of Lincoln Financial and are not subject to payment of agency fees.

Lincoln Financial is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.

This Employer Participates in E-Verify. See the E-Verify notices.

Este Empleador Participa en E-Verify. Ver el E-Verify avisos.

Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.