New York Life Insurance Company ยท 2 hours ago
Long Term Disability Claim Manager
United States
Full-time
Remote
Mid Level
$42K/yr - $70K/yr
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Responsibilities
Proactively manage your block of claims by regularly talking with and knowing your customers, their level of functioning, and having a command of case facts for each claim in your block
Develop and document Strategic Case Plans that focus on the future direction of the claim using a holistic viewpoint
Find customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented
Leverage claim dashboard to manage claim inventory to find which claims to focus efforts on for maximum impact
Have discussions with customers and employers regarding return to work opportunities and communicate with an action-oriented approach.
Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis
Ask focused questions of internal resources (e.g. nurse, behavioral, doctor, vocational) and external resources (customer, employer, treating provider) in order to question discrepancies, close gaps and clarify inconsistencies
Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information
Execute on all client performance guarantees
Respond to all communications within customer service protocols in a clear, concise and timely manner
Make fair, accurate, timely, and quality claim decisions
Adhere to standard timeframes for processing mail, tasks and outliers
Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.)
Clearly articulate claim decisions both verbally and in written communications
Understand Corporate Compliance, Policies and Procedures and best practices
Stay abreast of ongoing trainings associated with role and business unit objectives
Qualification
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Required
High School Diploma or GED required.
Proficiency with MS Office applications is required (Word, Outlook, Excel).
Excellent organizational and time management skills.
Strong critical thinker.
Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously.
Ability to focus and excel at quality production.
Strong written and verbal skills demonstrated in previous work experience.
Proven skills in positive and effective interaction with customers.
Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
Comfortable giving and receiving feedback.
Flexible to change.
Demonstrated analytical and math skills.
Preferred
Bachelor's degree strongly preferred.
Long Term Disability Claims experience preferred.
Experience in hospital administration, medical office management, financial services and/or business operations is a (+).
Specific experience with collaborative negotiations.
Experience in effectively meeting/exceeding personal professional expectations and team goals.
Benefits
401k
Medical
Dental
Vision
Tuition Reimbursement
Student Loan Repayment
Company
New York Life Insurance Company
For over 175 years, we've been helping people put love into action.
Founded in 1845
10,001+ employees
Funding
Current Stage
Late StageLeadership Team
Rohit Katti
CTO & Head of R&D Lab
Don Vu
Senior Vice President, Chief Data & Analytics Officer
Recent News
2024-04-28
2024-04-28
Company data provided by crunchbase
