Remote Insurance Claims Jobs in Oregon (NOW HIRING)

Location Designation: Fully Remote 

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:

• Make claim / customer eligibility determinations and manage on-going 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.
• 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.
• Support and promote all integration initiatives (including Family Medical Leave, Life Assistance Programs, Integrated Personal Health Team, Your Health First, Healthcare Connect, etc.).
• Ability to handle potentially high levels of call volume from customers and clients.
• Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits.
• Work directly with clients and Vocational Rehabilitation Counselors to facilitate return to work either on a full-time or modified duty basis.
• Network with both customers and physicians to medically manage claims from initial medical requests to reviewing and evaluating ongoing medical information.
• Pay all covered claims accurately and timely.
• Execute on all customer performance guarantees. 
• Adhere to standard timeframes for processing mail, tasks and outliers.
• Understand Group Benefit Solutions and Corporate Compliance, Polices and Procedures and best practices. 
• Stay abreast of ongoing trainings associated with role and business unit objectives.
• Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner. 

What You'll Bring:

• 2 year minimum of professional experience.
• Strong critical, analytical and investigative skills; ability to gather information, analyze facts, and draw conclusions.
• Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
• Ability to build and maintain effective relationships.
• Effective interpersonal, written and verbal communication skills.
• Excellent planning, time management and organizational skills.
• Ability to manage multiple and changing priorities.
• Strong negotiation skills.
• Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset.
• Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously.
• Proficiency with MS Office applications is required (Word, Outlook).
• Proven track record of successfully driving results in a complex matrix environment is a (+).
• Additional experience administering FMLA and/or State Leaves is a (+).
• Knowledge of legal liability, insurance coverage and medical terminology is a (+).
• HS Diploma or GED required. Bachelor's degree strongly preferred. 
  

Technology Requirements:
Functioning broadband (cable/DSL) should meet the following minimum requirements 50mb download/20mb upload speed. Ability to hardwire into internet connection required.

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Pay Transparency

Salary range: $42,500 - $57,500 

Overtime eligible: Nonexempt 

Discretionary bonus eligible: Yes 

Sales bonus eligible: No 

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.

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. In addition to base salary, employees may also be eligible to participate in an incentive program.

Our Benefits 

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. Click here to discover more about our comprehensive benefit options or visit our NYL Benefits Site.

Our Diversity Promise 

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. Click here to learn more about how we have been recognized for our leadership.

Recognized as one of Fortune's 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 Foundation. 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 Careers page of www.NewYorkLife.com.

Job Requisition ID: 94327 

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