Homeoffice Sr Disability Appeals Consultant bei Godirect

Together we fight for everyone’s opportunity for a better financial future.

We will do this together — with customers, partners and colleagues. We will fight for others, not against: We will stand up for and champion everyone’s access to opportunities. The status quo is not good enough … we believe every individual and every community deserves access to financial opportunities. We are determined to support both individuals and communities in reaching a better financial future.  We know that reaching this future depends on our actions today.

Like our Purpose Statement, Voya believes in being bold and committed to action.  We are committed to a work environment where the differences that we are born with — and those we acquire throughout our lives — are understood, valued and intentionally pursued. We believe that our employees own our culture and have a responsibility to foster an environment where we all feel comfortable bringing our whole selves to work. Purposefully bringing our differences together to positively influence our culture, serve our clients and enrich our communities is essential to our vision.

Are you ready to join a company with a strong purpose and a winning culture? Start your Voyage – Apply Now

Get to Know the Opportunity:  

The Disability Appeals role is responsible for managing and adjudicating appeals related to adverse claim determinations of Short-Term Disability (STD), Statutory and State Paid Family & Medical Leave benefits. This role ensures compliance with federal and state regulations, including ERISA guidelines, and delivers independent, fair, timely, and accurate determinations. The specialist serves as a key liaison between claimants, providers, legal representatives, and internal departments to resolve disputes and uphold organizational integrity.

Please Note: Work location for this role is FLEXIBLE! This position allows 100% remote work from home or allows work to be performed in any of our major office locations with a hybrid schedule. 

The Contributions You’ll Make:

• 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

Minimum Knowledge & Experience:

• 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

Preferred Knowledge & Experience:

• Bachelor’s degree
• Certification in Disability Management or Claims Handling (a plus)

#LI-IB1

#Remote

Compensation Pay Disclosure:

Voya is committed to pay that’s fair and equitable, which means comparable pay for comparable roles and responsibilities.

The below annual base salary range reflects the expected hiring range(s) for this position in the location(s) listed. In addition to base salary, Voya offers incentive opportunities (i.e., annual cash incentives, sales incentives, and/or long-term incentives) based on the role to reward the achievement of annual performance objectives. Please note that this salary information is solely for candidates hired to perform work within one of these locations, and refers to the amount Voya Financial is willing to pay at the time of this posting.

Actual compensation offered may vary from the posted salary range based upon the candidate’s geographic location, work experience, education, licensure requirements and/or skill level and will be finalized at the time of offer. Salaries for part-time roles will be prorated based upon the agreed upon number of hours to be regularly worked.

Be Well. Stay Well.

Voya provides the resources that can make a difference in your lives. To us, this means thriving physically, financially, socially and emotionally. Voya benefits are designed to help you do just that. That’s why we offer an array of plans, programs, tools and resources with one goal in mind: To help you and your family be well and stay well.

What We Offer

• Health, dental, vision and life insurance plans
• 401(k) Savings plan – with generous company matching contributions (up to 6%)
• Voya Retirement Plan – employer paid cash balance retirement plan (4%)
• Tuition reimbursement up to $5,250/year
• Paid time off – including 20 days paid time off, nine paid company holidays and a flexible Diversity Celebration Day.
• Paid volunteer time — 40 hours per calendar year

Learn more about Voya benefits (download PDF)

Critical Skills

At Voya, we have identified the following critical skills which are key to success in our culture:

• Customer Focused: Passionate drive to delight our customers and offer unique solutions that deliver on their expectations.
• Critical Thinking: Thoughtful process of analyzing data and problem solving data to reach a well-reasoned solution.
• Team Mentality: Partnering effectively to drive our culture and execute on our common goals.
• Business Acumen: Appreciation and understanding of the financial services industry in order to make sound business decisions.
• Learning Agility: Openness to new ways of thinking and acquiring new skills to retain a competitive advantage.

Learn more about Critical Skills

Equal Employment Opportunity

Voya Financial is an equal-opportunity employer. Voya Financial provides equal opportunity to qualified individuals regardless of race, color, sex, national origin, citizenship status, religion, age, disability, veteran status, creed, marital status, sexual orientation, gender identity, genetic information, or any other status protected by state or local law.