Voluntary Benefits Claims Manager

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<span class="jobdescription"><p> </p> <p><span style="font-size:14.0pt;font-family:tahoma, arial, helvetica, sans-serif;color:black"><strong>Location Designation: <strong><strong><strong><strong><strong><strong><strong>Fully Remote</strong></strong></strong></strong></strong></strong></strong> </strong></span></p> <p><span style="font-size:14.0pt;font-family:tahoma, arial, helvetica, sans-serif;color:black">Group Benefit Solutions delivers<strong> </strong>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<strong> </strong>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. <a style="color:black" href="https://www.newyorklife.com/group-benefit-solutions">Click here</a> to learn more about Group Benefits solutions.</span></p> <p> </p><p><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt"><strong>Role Overview:</strong></span></p> <p><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt"><strong><br></strong>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.</span></p> <p><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt"><strong>What You'll Do:</strong></span></p> <p><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Effectively communicate with claimants, employers, and various medical professionals both verbally and in writing to gather information necessary to aide in the claims process.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Daily adherence to New York Life & corporate compliance policies, procedures & best practices.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Focus on ongoing development via training associated with the role & business objectives while remaining current on any compliance-driven training curriculum.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Role may also require periodic Business Acceptance Testing (BAT) support as system enhancements are delivered.</span><br><br><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt"><strong>What You'll Bring:</strong></span></p> <p><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• High School diploma or GED required. BA/BS degree or equivalent work experience strongly preferred.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 2+ years of Group Benefits experience is strongly preferred.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Experience administering any GBS claims product (e.g., STD, LTD, FML/PFML, Life/AD&D) preferred.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Proficiency with MS office applications is required (Work, Outlook, Excel).</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• Ability to work with a bias for action and have a strong focus on service excellence.</span><br><span style="font-family:tahoma, arial, helvetica, sans-serif;font-size:14.0pt">• 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. </span></p><p><span style="font-size:14.0pt;font-family:tahoma, arial, helvetica, sans-serif">​</span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong>Pay Transparency</strong></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong>Salary range:</strong> $45,000-$70,000 </span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong>Overtime eligible:</strong> Nonexempt </span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong>Discretionary bonus eligible:</strong> Yes </span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong>Sales bonus eligible:</strong> No </span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif">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.</span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif">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.<strong> </strong>In addition to base salary, employees may also be eligible to participate in an incentive program.</span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong><span style="color:black">Our Benefits </span></strong></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><span style="color:black">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.<strong> </strong></span><a href="https://performancemanager8.successfactors.com/doc/custom/NYLPRD/6338_0524%20HR%20Talent%20Acquisition%20Employee%20Benefits%20PDF_GBS_FINAL.pdf"><span class="MsoHyperlink" style="color:blue"><u style="text-decoration:underline">Click here</u></span></a><strong> </strong><span style="color:black">to discover more about our comprehensive benefit options or visit our </span><span style="color:black"><a style="color:blue;text-decoration:underline" href="https://nylbenefits.com/">NYL Benefits Site</a></span><span class="MsoHyperlink" style="color:blue"><u style="text-decoration:underline">.</u></span><strong> </strong></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><strong><span style="color:black">Our Diversity Promise </span></strong></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><span style="color:black">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. <a style="color:blue;text-decoration:underline" href="https://www.newyorklife.com/newsroom/diversity-and-inclusion-awards">Click here</a> to learn more about how we have been recognized for our leadership.</span></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><span style="color:black">Recognized as one of </span><em><span style="color:black">Fortune’s</span></em><span style="color:black"> World’s Most Admired Companies, New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by the <a style="color:blue;text-decoration:underline" href="http://www.newyorklife.com/foundation">Foundation</a>. 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 <a style="color:blue;text-decoration:underline" href="https://www.newyorklife.com/about/careers/">Careers</a> page of <a style="color:blue;text-decoration:underline" href="http://www.NewYorkLife.com">www.NewYorkLife.com</a></span><span class="MsoHyperlink" style="color:blue"><u style="text-decoration:underline">.</u></span></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif">​<span style="color:#ffffff">Job Requisition ID: 94044 </span></span></p> <p><span style="font-size:12.0pt;font-family:tahoma, arial, helvetica, sans-serif"><span style="color:#ffffff">#GBS</span></span></p> </span>

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