New York Life Insurance Company · 10 hours ago
Short Term Disability Claims Manager
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Responsibilities
Make claim / customer eligibility determinations and manage on-going claims for an assigned caseload of short-term disability claims, through capturing medical information, applying appropriate contractual provisions, following legal guidelines, and leveraging expert resources.
Communicate with claimants, employers, and various medical professionals to gather information regarding the application for, payment of, and ongoing management of short-term disability benefits.
Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.).
Ability to handle potentially high levels of call volume from customers and clients. Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits.
Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis.
Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information.
Pay all covered claims accurately and timely.
Execute on all customer performance guarantees.
Adhere to standard timeframes for processing mail, tasks and outliers.
Understand Group Benefit Solutions and Corporate Compliance, Polices and Procedures and best practices.
Stay abreast of ongoing trainings associated with role and business unit objectives.
Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner.
Qualification
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Required
1 year minimum of professional experience.
HS Diploma or GED required.
Proficiency with MS Office applications is required (Word, Outlook).
Strong critical, analytical and investigative skills; ability to gather information, analyze facts, and draw conclusions.
Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
Ability to build and maintain effective relationships.
Effective interpersonal, written and verbal communication skills.
Excellent planning, time management and organizational skills.
Ability to manage multiple and changing priorities.
Strong negotiation skills.
Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously.
Functioning broadband (cable/DSL) should meet the following minimum requirements 50mb download/20mb upload speed.
Ability to hardwire into internet connection required.
Preferred
Bachelor’s degree strongly preferred.
Proven track record of successfully driving results in a complex matrix environment is a (+).
Additional experience administering FMLA and/or State Leaves is a (+).
Knowledge of legal liability, insurance coverage and medical terminology is a (+).
Benefits
Leave programs
Adoption assistance
Student loan repayment programs
Company
New York Life Insurance Company
For over 175 years, we've been helping people put love into action.
Funding
Current Stage
Late StageLeadership Team
Recent News
2024-04-28
2024-04-28
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