LTD (Long Term Disability) Claim Manager

<div><p> </p><p><span style=""><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="">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 href="https://www.newyorklife.com/group-benefit-solutions"><span style="color:#0000ff">Click here</span></a> to learn more about Group Benefits solutions.</span></p><p> </p><p><span style=""><strong>Role Overview:</strong></span><br><span style="">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.</span><br><br><span style="">The LTD Claim Manager will manage an assigned caseload of Long-Term Disability cases. This includes management of claims with longer duration and evolving medical conditions. LTD Claim Managers will partner with Team Leaders and Technical Coaches for guidance on having meaningful and transparent conversations with their customers and clinical partners to gather the information most relevant to each claim. It also requires potentially complex monthly benefit calculations, which will be reviewed for accuracy. The Claim Manager will also evaluate customer eligibility and interact with internal and external customers including, but not limited to, customers, employers, physicians, internal business matrix partners and attorneys, etc. to gather the information to make the decision on the claim.</span><br><br><span style=""><strong><span style="text-decoration: underline;">What You'll Do:</span></strong></span><br><br><span style="">As a Long-Term Disability Claim Manager, with oversight and on an increasing scheduled basis, you will -</span></p><ul><li style=""><span style="">Proactively manage your block of claims by regularly talking with and knowing your customers, their level of functioning, and having a command of case facts for each claim in your block.</span></li><li style=""><span style="">Develop and document Strategic Case Plans that focus on the future direction of the claim using a holistic viewpoint</span></li><li style=""><span style="">Determine customer eligibility by reviewing contractual language and medical documentation, interpret information and make decisions based on facts presented</span></li><li style=""><span style="">Leverage claim dashboard to manage claim inventory to determine which claims to focus efforts on for maximum impact</span></li><li style=""><span style="">Have probing conversations with customers and employers regarding return-to-work opportunities and communicate with an action-oriented approach.</span></li><li style=""><span style="">Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis</span></li><li style=""><span style="">Ask focused questions of internal resources (e.g., nurse, behavioral, doctor, vocational) and external resources (customer, employer, treating provider) to question discrepancies, close gaps and clarify inconsistencies</span></li><li style=""><span style="">Have detailed phone conversations with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information</span></li><li style=""><span style="">Execute on all client performance guarantees</span></li><li style=""><span style="">Respond to all communications within customer service protocols in a clear, concise, and timely manner</span></li><li style=""><span style="">Make fair, accurate, timely, and quality claim decisions</span></li><li style=""><span style="">Adhere to standard timeframes for processing mail, tasks, and outliers</span></li><li style=""><span style="">Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated</span></li><li style=""><span style="">Personal Health Team, Your Health First, Healthcare Connect, etc.)</span></li><li style=""><span style="">Clearly articulate claim decisions both verbally and in written communications</span></li><li style=""><span style="">Understand Corporate Compliance, Policies and Procedures and best practices</span></li><li style=""><span style="">Stay abreast of ongoing trainings associated with role and business unit objectives<br><br></span></li></ul><p><span style=""><strong><span style="text-decoration: underline;">What You'll Bring:<br><br></span></strong></span></p><ul><li style=""><span style="">High School Diploma or GED required, with 3 years minimum of professional experience or bachelor’s degree strongly preferred</span></li><li style=""><span style="">Experience in hospital administration, medical office management, financial services and/ or business operations is a (+)</span></li><li style=""><span style="">Comfortable talking with customers and having thorough phone conversations</span></li><li style=""><span style="">Excellent organizational and time management skills</span></li><li style=""><span style="">Strong critical thinker</span></li><li style=""><span style="">Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously</span></li><li style=""><span style="">Ability to focus and achieve production goals through high quality work</span></li><li style=""><span style="">Proficiency with MS Office applications is required (Word, Outlook, Excel)</span></li><li style=""><span style="">Strong written and verbal skills demonstrated in previous work experience</span></li><li style=""><span style="">Proven skills in positive and effective interaction with challenging customers</span></li><li style=""><span style="">Experience in effectively meeting/exceeding individual professional expectations and team goals</span></li><li style=""><span style="">Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset</span></li><li style=""><span style="">Comfortable giving and receiving feedback</span></li><li style=""><span style="">Flexible to change and highly cooperative</span></li><li style=""><span style="">Demonstrated analytical and math skills</span></li></ul><p><br><span style="">Critical Capabilities:</span></p><ul><li style=""><span style="">Critical Thinking</span></li><li style=""><span style="">Trust and Transparency</span></li><li style=""><span style="">Bias for Action</span></li><li style=""><span style="">Leads with Agility</span></li><li style=""><span style="">Customer Orientation</span></li></ul><p> </p><p><span style="">It is recommended that all qualified candidates apply to this posting as soon as possible.  Residents of Colorado are hereby notified that the deadline to apply is two weeks from the Posting Date listed above.</span></p><p> </p><p><span style="color: azure;">#LI-ML1</span></p><p><span style="color: azure;">#LI-REMOTE</span></p><p><span style="">​</span></p><p><span style=""><strong>Pay Transparency</strong></span></p><p><span style=""><strong>Salary range:</strong> $50,000-$71,500 </span></p><p><span style=""><strong>Overtime eligible:</strong> Nonexempt </span></p><p><span style=""><strong>Discretionary bonus eligible:</strong> Yes </span></p><p><span style=""><strong>Sales bonus eligible:</strong> No </span></p><p><span style="">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="">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=""><strong><span style="color:black">Our Benefits </span></strong></span></p><p><span style=""><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=""><strong><span style="color:black">Our Diversity Promise </span></strong></span></p><p><span style=""><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=""><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="">​<span style="color:#ffffff">Job Requisition ID: 92810 </span></span></p><p><span style=""><span style="color:#ffffff">#GBS</span></span></p></div>

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