Voluntary Benefit Claims Manager

Job Requisition ID:91249

Location Designation:Fully Remote

Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life's legacy of being there when we're needed most. Here, you'll design, implement, and support these solutions directly impacting employees' lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.

Role Overview:

New York Life Group Benefit Solutions (GBS) has begun a multi-year effort to expand into the Voluntary Benefits (VB) marketplace. We are confident that adding VB products into our comprehensive suite of product offerings will be a true differentiator for customers and claimants alike supporting them during moments that matter. We are seeking talented and capable claims expertise to join our team as we look to establish a new and exciting product with a best-in-class service experience.

As a VB Claims Manager, you will be assigned a caseload of VB claims that will consist of all VB products including Hospital Indemnity (HI), Accident (AI) & Critical Illness (CI). Primary duties will include conducting thorough investigations to determine eligibility, liability and financial accuracy of all claims received. A key component of this role will also include a focus on providing a service excellence experience that is second to none.

What You'll Do:

• Accountable for managing a caseload of claims that will include all VB products as well as Wellness offerings where appropriate. New claim submissions may be received telephonically, via paper form or digitally. Proactive claims processing may also occur based on customer agreements.
• Determine eligibility of benefits by reviewing contractual language alongside medical information leading to accurate and timely claims decisions. These decisions should have a focus on overall quality outcomes that deliver a best-in-class experience marked by our service excellence approach
• Perform multi-policy checks where appropriate to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits as a result of their condition(s) in support of GBS service integration initiatives.
• Effectively communicate with claimants, employers, and various medical professionals both verbally and in writing to gather information necessary to aide in the claims process.
• Respond to all telephonic and email inquiries within established customer service protocols while also adhering to standard timeframes. Should also ensure execution on all customer performance guarantees as defined.
• Must document clear and concise claims notes based on all documentation received/reviewed as well as conversations with the customer, provider, or claimant to support rationale for determinations.
• Work collaboratively across both the VB claims team as well as the broader GBS claims organization to ensure a cohesive business unit driving to deliver customer value.
• Daily adherence to New York Life & corporate compliance policies, procedures & best practices.
• Focus on ongoing development via training associated with the role & business objectives while remaining current on any compliance-driven training curriculum.
• Given the newness of the VB product suite, Claims Managers may be asked to aide in validating accuracy and appropriateness of technology builds within the claims system. This is critical to ensure that the team is enabled to be successful while maximizing technology to increase efficiency.
• Role may also require periodic Business Acceptance Testing (BAT) support as system enhancements are delivered.

What you'll bring:

• High School diploma or GED required. BA/BS degree or equivalent work experience strongly preferred.
• 2+ years of Group Benefits experience is strongly preferred.
• Experience administering any GBS claims product (e.g., STD, LTD, FML/PFML, Life/AD&D) preferred.
• Proficiency with MS office applications is required (Work, Outlook, Excel).
• Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously.
• Strong critical thinking, analytical and investigative skills with the ability to gather information, analyze facts & draw conclusions. This paired with strong verbal & written communication skills is needed to develop comprehensive claims records.
• Ability to work with a bias for action and have a strong focus on service excellence.
• Effective interpersonal, written and verbal communication skills including the ability to explain complex claim scenarios. A key capability includes the ability to translate complex situations into easily understandable language for customers and claimants.
• Attention to detail is critical to effectively handle the technical aspects of the job. This includes the ability to review and interpret customer-specific policy documentation spanning all VB product offerings while considering potential additional benefits a claimant may be eligible for.
• Excellent planning, time management and organizational skills. Ability to manage multiple priorities simultaneously as required while strong critical thinking and analytical skills to effectively multi-task in order to meet tight deadlines.
• Knowledge of legal liability, insurance coverage and medical terminology is helpful.
• A proven track record of successfully driving results in a complex matrixed environment.
• Ability to build and maintain effective relationships.

This position can be offered as a full-time work from home position for candidates with appropriate experience.

It is recommended that all qualified candidates apply to this posting as soon as possible. Residents of Colorado are hereby notified that the deadline to apply is 2 weeks from the Posting Date listed above.

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Pay Transparency

Salary range:$40,000-$70,000

Overtime eligible:Nonexempt

Discretionary bonus eligible:Yes

Sales bonus eligible:No

Actual base salary will be determined based on several factors but not limited to individual's experience, skills, qualifications, and job location. Additionally, employees are eligible for an annual discretionary bonus. In addition to base salary, employees may also be eligible to participate in an incentive program.

Actual base salary within that range will be determined by several components including but not limited to the individual's experience, skills, qualifications, and job location. In addition to base salary, employees may also be eligible to participate in an incentive program.

Our Benefits

We provide a full package of benefits for employees - and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Click here to discover more about our comprehensive benefit options or visit our NYL Benefits Site.

Our Diversity Promise

We believe in a diverse workforce because it is our mission to advocate for the financial security and success of people in every community. This is why diversity, equity, and inclusion (DEI) are guiding principles that are embedded in our brand and our culture. Click here to learn more about how we have been recognized for our leadership.

Recognized as one of Fortune's World's Most Admired Companies, New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by theFoundation.We're proud that due to our mutuality, we operate in the best interests of our policy owners. To learn more about career opportunities at New York Life, please visit the Careers page of www.NewYorkLife.com.

Job Requisition ID:91249