[Hiring] Long Term Disability Claim Manager @New York Life Insurance Co

Role Description

The LTD Claim Manager is responsible for accomplishing training requirements, learning, and applying the LTD concepts gained in classroom and on-the-job training to successfully manage an assigned LTD caseload. The Claim Manager is responsible for the development of strategic case plans informed by customer & key stakeholder interactions, leveraging Technical Coaches and Team Leaders where appropriate. As a key customer-facing role, the Claim Manager will communicate with customers, employers, and treating providers.

The LTD Claim Manager will manage an assigned caseload of Long-Term Disability cases, including:

• Management of claims with longer duration and evolving medical conditions.
• Partnering with Team Leaders and Technical Coaches for guidance.
• Conducting potentially complex monthly benefit calculations.
• Evaluating customer eligibility and interacting with various stakeholders.

What You'll Do

• Proactively manage your block of claims by regularly talking with and knowing your customers.
• Develop and document Strategic Case Plans that focus on the future direction of the claim.
• Determine customer eligibility by reviewing contractual language and medical documentation.
• Leverage claim dashboard to manage claim inventory.
• Have probing conversations with customers and employers regarding return-to-work opportunities.
• Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work.
• Ask focused questions of internal and external resources to clarify inconsistencies.
• Have detailed phone conversations with both customers and physicians to manage claims.
• Execute on all client performance guarantees.
• Respond to all communications within customer service protocols.
• 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.

Qualifications

• High School Diploma or GED required, with 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.
• Must be 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 is required (Word, Outlook, Excel).
• 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.
• Must have the 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.

Critical Capabilities

• Critical Thinking
• Trust and Transparency
• Bias for Action
• Leads with Agility
• Customer Orientation

Requirements

• Salary range: $50,000-$71,500
• Overtime eligible: Nonexempt
• Discretionary bonus eligible: Yes
• Sales bonus eligible: No

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.