Short Term Disability Claims Manager

New York Life Insurance Company; New York (NY); On-site; USD 50,000 - 90,000; Full time

Job summary

An established industry player is seeking a Short Term Disability Claims Manager to enhance their Group Benefit Solutions team. This role is pivotal in ensuring that employees receive the support they need during critical times. You will be responsible for managing claims, conducting thorough investigations, and communicating effectively with various stakeholders. Your attention to detail and ability to work under pressure will directly impact the well-being of clients. This position offers a dynamic work environment where your contributions will foster a healthier workforce and uphold the legacy of providing peace of mind through comprehensive insurance solutions.

Qualifications

• Minimum 1 year of professional experience required.
• Strong analytical and communication skills are essential.
• Knowledge of legal liability and insurance coverage is a plus.

Responsibilities

• Manage short-term disability claims and determine eligibility.
• Communicate with claimants and medical professionals effectively.
• Handle high volumes of customer inquiries regarding claims.

Skills

Analytical Skills

Communication Skills

Customer Service

MS Office Proficiency

Investigation Skills

Time Management

Relationship Building

Critical Thinking

Education

High School Diploma or GED

Bachelor's Degree

Tools

MS Office (Word, Outlook)

Job 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. 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:

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.

What You'll Do:

1. Make claim / customer eligibility determinations and manage ongoing 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.
2. 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.
3. Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.).
4. Handle high volumes of calls from customers and clients. Respond to inquiries regarding eligibility, approval/denial, benefits status, and continuation or closure.
5. Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work on full or modified duty basis.
6. Network with customers and physicians to medically manage claims from initial requests to ongoing evaluations.
7. Pay all covered claims accurately and timely.
8. Execute all customer performance guarantees.
9. Adhere to standard timeframes for processing mail, tasks, and outliers.
10. Understand Group Benefit Solutions, Corporate Compliance, Policies, Procedures, and best practices.
11. Stay updated with ongoing training related to role and business objectives.
12. Respond to all inquiries via phone and email within customer service protocols, clearly, concisely, and promptly.

What You'll Bring:

1. Minimum 1 year of professional experience.
2. HS Diploma or GED required; Bachelor's degree strongly preferred.
3. Proficiency with MS Office applications (Word, Outlook).
4. Proven success in results-driven environments, especially in complex matrix organizations (+).
5. Strong analytical, investigative, and critical thinking skills.
6. Experience with FMLA and/or State Leaves (+).
7. Ability to work with urgency, be a self-starter, and focus on customer needs.
8. Effective relationship-building skills.
9. Excellent communication skills, both written and verbal.
10. Strong planning, organizational, and time management skills.
11. Ability to handle multiple priorities and adapt to change.
12. Knowledge of legal liability, insurance coverage, and medical terminology (+).
13. Technically savvy with multitasking across applications and monitors.
14. Reliable broadband internet (minimum 50mb download/20mb upload). Hardwired connection preferred.