Quality Review Specialist- Group Life Insurance; Group Insurance Claims

Primary Location

UNITED STATES-Remote

UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse

Equitable

Full-time

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 an influential and dynamic Group Life Quality Specialist to join our Life, Disability and Absence Claims organization. The Quality Specialist is responsible for the quality review of Group Life and Individual Life claim processing. Ideal candidates will have a creative mindset for developing and operating a Quality Program with a lens on the customer experience.

• Quality Assurance:
  • Conduct thorough reviews of Individual & Group Life claims to ensure compliance with internal, state and regulatory requirements.
  • Share feedback with a coaching mindset with a focus on talent development and continuous improvement.
• Process Improvement:
  • Collaborate with cross-functional teams to identify opportunities for improvement in current processes.
  • Stay updated on changes in insurance regulations and industry best practices.
  • Partner with teams to develop innovative solutions to elevate outcomes and customer experience.
• Program Development:
  • Assist in establishing and building a comprehensive quality program tailored to the needs of our organization.
• Technical Expertise:
  • Apply technical knowledge to evaluate and enhance the effectiveness of Life Claims and Waiver programs.
• Data Analysis:
  • Analyze data and generate reports to track performance metrics and identify emerging trends or opportunities.

The base salary range for this position is $50,000 - $65,000. 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, see below.

Equitable Total Rewards Program

Required Qualifications

• Excellent organizational and time management skills with ability to multitask and prioritize deadlines.
• Ability to manage multiple and changing priorities.
• Detail oriented; able to analyze and research contract information.
• Demonstrated ability to operate with a sense of urgency.
• Experience in effectively meeting/exceeding individual professional expectations and team goals.
• Demonstrated analytical and math skills.
• Ability to exercise critical thinking skills, risk management skills and sound judgment.
• Ability to adapt, problem solve quickly and communicate effective solutions.
• High level of flexibility to adapt to the changing needs of the organization.
• Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment.
• Continuous improvement mindset.

• Prior experience with Quality Review is beneficial.
• Strong analytical skills with excellent attention to detail.
• Ability to think creatively and propose innovative solutions for Quality Program development and continuous improvement.
• Comfortable dealing with complexity and ambiguity and able to explore multiple solutions.
• Previous experience with FINEOS Claims software platform preferred, but not required.

Claims Management: Comprehensive understanding of insurance policies, coverage terms, medical classification and claims adjudication procedures.

Effective Communications: Excellent written and verbal communication to effectively convey information to diverse audiences including legal professionals, policy holders and internal stakeholders.

Information Analysis and Interpretation: Ability to critically evaluate complex medical records, policy language to make informed insight on claims management and strategy. Strong analytical and problem-solving skills. Maintain accurate records of all cases in system of record.

At Equitable, we’re a team 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,…