Title: Disability and Leave Management Claims Specialist (REMOTE) Location: United States Job Description: UNITED STATES-Remote Other Locations : UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse Organization : Equitable Schedule : Full-time About the Role At Equitable, we help clients secure their financial well-being so they can pursue long and fulfilling lives- a mission we’ve honed since 1859. Equitable is looking for an experienced Claims Specialist supporting Disability and Leave Management claims to join our team! The Claims Specialist is responsible for providing excellent customer service. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions and partner with internal and external resources. Reliability and dependability throughout our extensive training program is required. What You’ll Be Doing - Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved - Communication via telephone, email, and text with employees, employers, attorneys, and others - Review and interpret medical records, utilizing resources as appropriate - Complete financial calculations - Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication - Apply contract/policy provisions to ensure accurate eligibility and liability decisions - Demonstrate and apply analytical and critical thinking skills - Verify on-going liability and develop strategies for return-to-work opportunities as appropriate - Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication - Leverage a broad spectrum of resources, materials, and tools to render claims decisions - Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards - Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities - Work independently as well as within a team structure This position offers a remote work schedule that allows you to stay fully engaged with your team to provide outstanding, customer‑focused service during our core hours (8:30 AM–5:30 PM EST). Periodic office visits may be requested based on business needs. The base salary range for this position is $50,000-$60,000. 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 What You Will Bring - Bachelor’s degree or equivalent work experience - 1+ years disability claims experience - Exceptional customer service skills - Maintains positive and effective interaction with challenging customers - Strong knowledge of disability and leave laws and regulations - Ability to handle sensitive information with confidentiality and professionalism Preferred Qualifications - Group Disability Claims experience - Exceptional written and oral communication skills demonstrated in previous work experience - 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 - A commitment to support a work environment that fosters diversity and inclusion - Proficiency in computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word Skills Analytical Thinking: Knowledge of techniques and tools that promote effective analysis; ability to determine the root cause of organizational problems and create alternative solutions that resolve these problems. Customer Support Operations: Knowledge of customer support techniques, tools, technologies, and best practices; ability to utilize all aspects of customer support operations to manage a call center. Customer Support Systems: Knowledge of principles and techniques used in customer support and ability to use applications, hardware, software, networking, and the applications environment used for customer support. Managing Multiple Priorities: Knowledge of effective self-management practices; ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation. Problem Solving: Knowledge of approaches, tools, techniques for recognizing, anticipating, and resolving organizational, operational or process problems; ability to apply knowledge of problem solving appropriately to diverse situations. #LI-Remote About Equitable 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, 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. 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.

• Review, validate, and process NEMT claims in accordance with Medicaid policies, GOBHI program guidelines, and contractual requirements. • Perform accurate billing and coding for NEMT claims using appropriate HCPCS/CPT codes. • Verify member eligibility, trip authorization, and service documentation prior to submission. • Ensure claims are submitted within required timelines and track adjudication through final payment. • Identify and resolve claim errors, discrepancies, and denials in coordination with providers and program staff. • Maintain current knowledge of Medicaid billing codes, guidelines, and NEMT-specific requirements. • Conduct regular audits of NEMT claims to detect and prevent errors, overpayments, or potential fraud. • Support corrective action plans and recommend process improvements to strengthen billing integrity. • Accurately code trips and services in compliance with Medicaid and NEMT guidelines. • Prepare, review and submit billing batches to Medicaid and other payers. • Reconcile claims against payments, identifying variances or unpaid balances. • Collaborate with GOBHI finance staff to support accurate accounting and reporting. • Generate and maintain reports on claims activity, denial rates, and reimbursement trends. • Provide data analysis to identify cost drivers, claim patterns, and areas for improvement. • Serve as a resource for NEMT providers regarding Medicaid billing procedures, documentation, and claim resolution. • Upon supervisor’s approval and direction, update and maintain provider rate contracts. • Provide training and technical assistance to providers on coding, billing, and submission processes. • Other duties as assigned.

Title: Claims Officer Locations: AUS - NSW - Newcastle AUS - NSW - Parramatta Hybrid time type Full time job requisition id 355267 Job Description: Primary Details Time Type: Full time Worker Type: Employee Please see more information about QBE careers here - Open to all QBE office locations nationally - 12-month fixed term contracts, full-time hours - Hybrid roles - a mix of in office and work from home The opportunity We are looking for experienced Claims Officer's to join our catastrophe claims team, managing end-to-end property claims from major events like hail, cyclones, storms, floods, and bushfires. This hybrid role offers the chance to work autonomously while being part of a fast-paced, supportive team that values resilience, trust, and a strong work ethic. About QBE At QBE, we get to the heart of what matters for our customers. And we do it all with a human touch. We're an international insurer with more than 13,000 people working across 26 countries - which means we're big enough for your ambitions, yet small enough for you to make a real impact. It's an exciting time. We're building momentum towards our vision to become the most consistent and innovative risk partner. What if you could have a positive impact - at work and in the world? As part of the QBE team, you'll get to spend every day working with people who are passionate, talented and kind. Your new role - Manage end-to-end catastrophe claims across events such as hail, cyclones, storms, floods, and bushfires. - Apply case management expertise to assess, process, and resolve claims efficiently and empathetically. - Handle property claims with accuracy and compliance, ensuring timely and fair outcomes for customers impacted by catastrophic events. - Operate independently in a hybrid environment while contributing to a high-performing, collaborative team. - Demonstrate resilience and sound judgement in a fast-paced, high-pressure setting. - Uphold behavioural standards and foster trust through clear communication and ethical decision-making. About you - Experienced within property claims case management, domestic or commercial. - Quick to adapt and thrive in fast-paced, dynamic environments. - Demonstrates resilience and a strong work ethic when managing complex claims. - Confident working independently while contributing positively to team outcomes. - Committed to integrity, accountability, and clear, professional communication. Benefits We offer a range of benefits to help provide holistic support for your work life, whatever your circumstances. As a QBE employee you will have access to and benefit from: - 'Hybrid Working' - a mix of working from home and in the office to enhance your work/life balance - Free holistic wellbeing coaching, nutritional, confidential counselling, financial and legal advice - 18 weeks' gender-equal flexible leave for all new parents, including paid super To learn more about benefits of working with us, click here. Rewards & Recognition We value our employee's experience with us and are proud to have been recognised for the following awards: - 2025 Winner of Excellence in Diversity, Equity & Inclusion Award at the Insurance Business Australia Awards for our Respect@QBE program - 2023 Most Inclusive Workplace at the Australian HR Institute (AHRI) Awards - Ranked in the top ten in the AAGE Top Graduate Employers 2025 for medium sized program as voted by graduates Skills: Case Management, Claims Settlement, Collaboration Tools, Communication, Critical Thinking, Customer Service, Data Privacy, Detail-Oriented, Insurance Policies, Intentional collaboration, Managing performance, Prioritization, Problem Solving, Risk Assessments, Standards Compliance

• Set-up and process new accounts daily. • Effectively use company systems and technologies to successfully enter content information and verify information received. • Effectively communicate with patients, attorneys, and insurance carriers. • Establish and maintain a positive working relationship with internal and external partners. • Display quality work, integrity, and ethical decision making during all work assignments. • Display the ability to problem solve. • Work in a team environment handling complex high-volume work. • Adhere to high standards of accountability, confidentiality (HIPAA compliant), and professionalism while dealing with medical and financial information.