Short Term Disability Claims Manager

New York Life•New York, NY

1d•$42,500 - $65,500•Remote

About The Position

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. As a Short Term Disability (STD) Claims Manager, you will develop the knowledge and skills needed to conduct thorough investigations, make determinations regarding short-term disability eligibility for our customers, provide ongoing claim administration, and communicate decisions and status updates. This is a fast-paced job where attention to detail counts. The Claim Manager’s decisions have a direct impact on customers’ health, well-being and sense of security. The ability to make and effectively communicate decisions within tight timeframes, while integrating knowledge of medical conditions, customer contracts, Group Benefit Solutions and corporate compliance are critical for success.

Requirements

2 year minimum of professional experience.
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.
Proficiency with MS Office applications is required (Word, Outlook).
HS Diploma or GED required.

Nice To Haves

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 (+).
Bachelor’s degree strongly preferred.

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.