Voluntary Benefits Claims Manager

New York Life•New York, NY

5d•$46,500 - $73,500•Remote

About The Position

New York Life’s Group Benefit Solutions delivers insurance and absence management solutions for mid-sized and large companies. The Voluntary Benefits Claims Manager manages claims across Hospital Indemnity, Accident, and Critical Illness products, as well as Wellness offerings where appropriate. The role investigates claims to determine eligibility, liability, and financial accuracy, and aims to provide a high-quality service experience. Claims may arrive by phone, paper, or digitally, and proactive processing may occur under customer agreements. The position is fully remote and nonexempt, with eligibility for a discretionary annual bonus and possible participation in an incentive program.

Requirements

High school diploma or GED required.
Proficiency with Microsoft Office applications, including Word, Outlook, and Excel.
Technical aptitude and ability to switch between multiple applications and/or computer monitors simultaneously.
Strong critical-thinking, analytical, and investigative skills, including the ability to gather information, analyze facts, and draw conclusions.
Strong verbal and written communication skills to develop comprehensive claims records.

Nice To Haves

Bachelor of Arts or Bachelor of Science degree, or equivalent work experience.
At least 2 years of Group Benefits experience.
Experience administering a Group Benefit Solutions claims product, such as STD, LTD, FML/PFML, or Life/AD&D.

Responsibilities

Manage a caseload of claims across Voluntary Benefits products and applicable Wellness offerings, including submissions received by phone, paper, or digital channels and proactive processing under customer agreements.
Review contractual language and medical information to determine benefit eligibility and make accurate, timely claims decisions focused on quality and service excellence.
Conduct multi-policy checks to identify whether claimants with active disability and/or Life claims may qualify for additional Voluntary Benefits.
Communicate verbally and in writing with claimants, employers, and medical professionals to gather information needed for claims processing.
Respond to phone and email inquiries within customer service protocols and standard timeframes, and meet customer performance guarantees.
Document clear and concise claims notes based on records reviewed and conversations, supporting the rationale for determinations.
Collaborate with the Voluntary Benefits claims team and the broader Group Benefit Solutions claims organization.
Follow New York Life and corporate compliance policies, procedures, and best practices.
Complete ongoing role- and business-related training and remain current with compliance training.
Help validate the accuracy and appropriateness of claims-system technology builds and, periodically, support Business Acceptance Testing for system enhancements.