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About the Role
Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies, fostering a healthier, happier, and more secure workforce. This role involves designing, implementing, and supporting solutions that directly impact employees' lives, providing financial security and peace of mind through absence, accident, disability, voluntary benefits, and life insurance solutions.
Responsibilities
- Manage an assigned caseload of Long-Term Disability claims, including those with longer durations and evolving medical conditions.
- Develop and document Strategic Case Plans focusing on the future direction of the claim using a holistic viewpoint.
- Determine customer eligibility by reviewing contractual language and medical documentation, interpreting information, and making decisions based on facts.
- Leverage claim dashboards to manage claim inventory and prioritize efforts for maximum impact.
- Conduct probing conversations with customers and employers regarding return-to-work opportunities with an action-oriented approach.
- Collaborate with clients and Vocational Rehabilitation Counselors to facilitate return to work.
- Ask focused questions of internal and external resources to clarify discrepancies and gather necessary information.
- Conduct detailed phone conversations with customers and physicians to medically manage claims.
- Execute on all client performance guarantees.
- Respond to all communications within customer service protocols in a clear, concise, and timely manner.
- Make fair, accurate, timely, and quality claim decisions.
- Adhere to standard timeframes for processing mail, tasks, and outliers.
- Support and promote all integration initiatives.
- Clearly articulate claim decisions both verbally and in written communications.
- Understand Corporate Compliance, Policies and Procedures, and best practices.
- Stay abreast of ongoing trainings associated with role and business unit objectives.
Requirements
- High School Diploma or GED required.
- 3 years minimum of professional experience or bachelor’s degree strongly preferred.
- Experience in hospital administration, medical office management, financial services and/or business operations is a plus.
- Comfortable talking with customers and having thorough phone conversations.
- Excellent organizational and time management skills.
- Strong critical thinker.
- Technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously.
- Ability to focus and achieve production goals through high-quality work.
- Proficiency with MS Office applications (Word, Outlook, Excel) is required.
- Strong written and verbal skills demonstrated in previous work experience.
- Proven skills in positive and effective interaction with challenging customers.
- Experience in effectively meeting/exceeding individual professional expectations and team goals.
- Ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
- Comfortable giving and receiving feedback.
- Flexible to change and highly cooperative.
- Demonstrated analytical and math skills.
Skills
- Critical Thinking
- Trust and Transparency
- Bias for Action
- Leads with Agility
- Customer Orientation
Location
- Fully Remote
Work Type
- Full-time
Experience Level
- 3 years minimum of professional experience
Education Level
- High School Diploma or GED
- Bachelor's degree strongly preferred
Salary/Compensations
- $50,000-$71,500
Benefits
- Full package of benefits
- Leave programs
- Adoption assistance
- Student loan repayment programs
About the Company
- Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies.
- New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by the Foundation.
- New York Life operates in the best interests of its policy owners due to its mutuality.
Equal Opportunity
- 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.
- Recognized as one of Fortune’s World’s Most Admired Companies.