Voluntary Benefits Claims Manager

Role Description

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.

• Accountable for managing a caseload of claims that will include all VB products as well as Wellness offerings where appropriate.
• Determine eligibility of benefits by reviewing contractual language alongside medical information leading to accurate and timely claims decisions.
• Perform multi-policy checks to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits.
• Effectively communicate with claimants, employers, and various medical professionals both verbally and in writing.
• Respond to all telephonic and email inquiries within established customer service protocols.
• Document clear and concise claims notes based on all documentation received/reviewed.
• Work collaboratively across both the VB claims team and the broader GBS claims organization.
• Daily adherence to New York Life & corporate compliance policies, procedures & best practices.
• Focus on ongoing development via training associated with the role & business objectives.
• Aide in validating accuracy and appropriateness of technology builds within the claims system.
• Periodic Business Acceptance Testing (BAT) support as system enhancements are delivered.

Qualifications

• 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.
• Effective interpersonal, written and verbal communication skills.

Requirements

• Ability to work with a bias for action and have a strong focus on service excellence.
• Ability to explain complex claim scenarios in easily understandable language for customers and claimants.

Benefits

• Full package of benefits for employees including leave programs, adoption assistance, and student loan repayment programs.
• Continuous refinement and addition of benefits based on employee feedback.

Company Description

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.