Responsibilities BH Shared Services (a UHS company) located in Brentwood, TN is currently seeking an experienced Market Appeals Specialist to join our established team. POSITION SUMMARY: Market Appeals Specialist This position supports utilization management and shared services within the behavioral health division. This role oversees and completes all standard appeals within a designated market, including both Cerner and non-Cerner facilities. A successful candidate must have knowledge of utilization management operations, including experience with appeal letters and payer engagement. The ability to apply clinical acumen in a behavioral health setting both verbally and in writing is essential to this role. *This is a fully remote position. RESPONSIBILITIES: - Complete all standard appeals timely and manage appeal inventory through ongoing tracking and monitoring. - Act as a liaison with local facilities and payers to ensure timely appeal processing including appropriate follow-up with payers for facility reimbursement. - Participate in local facility UM team meetings to support the standard appeal process. - Provide feedback to providers and UM team on opportunities impacting facility recoveries (e.g., documentation) - Performs other duties as assigned/required by this position This opportunity provides the following: - UHS offers a challenging and rewarding work environment - Growth and development opportunities within UHS and its subsidiaries - Competitive Compensation - Excellent Medical, Dental, Vision and Prescription Drug Plan. - 401k plan with company match - Generous Paid Time Off - Gym and workout area About Universal Health Services One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, annual revenues were $15.8 billion in 2024. UHS was again recognized as one of the World’s Most Admired Companies by Fortune; listed in Forbes ranking of America’s Largest Public Companies. Headquartered in King of Prussia, PA, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. www.uhs.com Qualifications REQUIREMENTS: - Bachelor's degree required, Master's preferred - RN License or Master's level clinician required,Licenusre preferred - 3-5 years related experience required, 5-8 preferred - Knowledge of utilization management operations, including experience with appeal letters and payer engagement. - Proficient in Excel, Microsoft Office/Teams, Word, and database inventory management. - Knowledge of payer requirements for reimbursement across all levels of care and behavioral health business office operations. - Strong oral communication skills to represent patient progress and treatment in behavioral health. - Understanding of medical necessity criteria application for all levels of care. - Ability to apply clinical acumen in behavioral health to written correspondence. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. Avoid and Report Recruitment Scams We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information. At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

🌟 Disability Benefit Specialist – Remote 🌟 Make an impact from anywhere—and love what you do! What’s in it for you? ✅ Work remotely—your office, your vibe! ✅ Help people when they need it most. ✅ Be part of a team that values compassion, clarity, and results. Join us as a Disability Benefit Specialist and play a key role in evaluating claims, determining benefit eligibility, and guiding employees toward successful return-to-work strategies. Use your expertise in disability policies and medical/vocational issues to deliver clear, timely decisions and exceptional support. Why Crawford? Because a claim is more than a number — it’s a person, a child, a friend. It’s anyone who looks to Crawford on their worst days. And by helping to restore their lives, we are helping to restore our community – one claim at a time. At Crawford, employees are empowered to grow, emboldened to act and inspired to innovate. Our industry-leading team pioneers new solutions for the industries and customers we serve. We’re looking for the next generation of leaders to take this journey with us. We hail from more than 70 countries and speak dozens of languages, reflecting the global fabric of the audience we serve. Though our reach is vast, we proudly operate as One Crawford: united in purpose, vision and values. Learn more at www.crawco.com. When you accept a job with Crawford, you become a part of the One Crawford family. Our total compensation plans provide each of our employees with far more than just a great salary - Pay and incentive plans that recognize performance excellence - Benefit programs that empower financial, physical, and mental wellness - Training programs that promote continuous learning and career progression while enhancing job performance - Sustainability programs that give back to the communities in which we live and work - A culture of respect, collaboration, entrepreneurial spirit and inclusion Crawford & Company participates in E-Verify and is an Equal Opportunity Employer. M/F/D/V Crawford & Company is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at Crawford via-email, the Internet or in any form and/or method without a valid written Statement of Work in place for this position from Crawford HR/Recruitment will be deemed the sole property of Crawford. No fee will be paid in the event the candidate is hired by Crawford as a result of the referral or through other means.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description In this role, you’ll leverage your expertise in claims adjudication, contract interpretation, and risk management to guide clients, overcome obstacles, and ensure fair, compliant decisions. You’ll collaborate with internal teams and the Law Division, communicate clearly and professionally with claimants and stakeholders, and manage multiple priorities with accuracy and attention to detail. This role also offers the opportunity to mentor and support staff while continuously improving processes and efficiency. What You'll Do - Reviews and evaluates all pre- and post-adverse benefit determination materials for Group STD, LTD, Life, AD&D, Waiver of Premium, CI and Accident appeals; overcomes objections through effective appeal arguments, escalates appropriately, and requests additional information as needed to clarify issues. - Renders appeal decisions using medical, vocational and legal risk management resources; serves as a technical expert to guide client appeal activities and leverages contract language to support sound determinations. - Prepares clear, professional written communications to claimants, representatives, policyholders, brokers and attorneys; documents actions thoroughly and maintains accurate records of appeal cause, disposition and trending. - Ensures compliance with ERISA and applicable federal and state laws; researches and evaluates emerging case law and regulatory changes, presents cases in forums, and remains current on company, industry and legislative updates. - Drives continuous improvement by identifying technological and process enhancements; mentors and trains staff and clients on appeals and risk management, contributes to internal policy development, and partners with operations to ensure alignment on key processes. Qualifications - Minimum of 10 years of Group Disability experience, thorough understanding of claims adjudication, benefit determination, investigation, file development, legal requirements, and contract interpretation, with the ability to conduct focused and extensive claims research. - Demonstrated high-level risk management, analytical, mathematical, problem-solving, and decision-making skills, with strong persuasion, negotiation, and ability to interpret and communicate disability contract language. - Excellent communication skills with the ability to remain professional and pleasant in interactions with coworkers, clients, claimants, vendors, and others; capable of conducting small group presentations and collaborating with the Law Division, including potential participation in depositions or trials. - Ability to de-escalate situations on a regular basis and manage multiple priorities effectively. - Superior attention to detail, flexibility, and the ability to work independently or as part of a team. - You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do. - Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico. Benefits - Estimated Salary: (Levels have variable responsibilities and qualifications): - Appeals Specialist: $54,000 - $66,000 plus annual bonus opportunity. - Sr Appeals Specialist: $68,000 - $90,000 plus annual bonus opportunity. - 401(k) plan with a 2% company contribution and 6% company match. - Work-life balance with vacation, personal time and paid holidays.

Introduction At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose. Overview Role specifics: - Jurisdictions: NY - Licenses: NY - This role is eligible for fully remote work How you'll make an impact - Apply claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims - Interact extensively with various parties involved in the claim process to ensure effective communication and resolution - Provide exceptional customer service to our claimants on behalf of our clients exhibiting empathy through each step of the claims process - Handle claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethics requirements - Document and communicate claim activity timely and efficiently, supporting the outcome of the claim file About You Ideal candidates for this position will have: - Claims Background: workers compensation lost time/indemnity experience - Jurisdictional Experience: NY - Active Adjusters' licenses: NY As a key member of our experienced Claims Adjuster team, you will: - Investigate, evaluate, and resolve complex workers compensation claims applying your analytical skills to make informed decisions and bring claims to resolution - Work in partnership with our clients to deliver innovative solutions and enhance the claims management process - Think critically, solve problems, plan, and prioritize tasks to optimally serve clients and claimants Required Qualifications: - High School Diploma - Minimum of 5 years related claims experience - Appropriately licensed and/or certified in all states in which claims are being handled - Knowledge of accepted industry standards and practices - Computer experience with related claims and business software Desired: - Bachelor's Degree #LI-REMOTE #LI-KQ1 Compensation and benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve: - Medical/dental/vision plans, which start from day one! - Life and accident insurance - 401(K) and Roth options - Tax-advantaged accounts (HSA, FSA) - Educational expense reimbursement - Paid parental leave Other benefits include: - Digital mental health services (Talkspace) - Flexible work hours (availability varies by office and job function) - Training programs - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing - Charitable matching gift program - And more... **The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process. We value inclusion and diversity Click Here to review our U.S. Eligibility Requirements Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work. Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest. Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws. Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.