Voluntary Benefit Claims Manager

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 through absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions. Role Overview As a VB Claims Manager, you will be assigned a caseload of VB claims that will consist of all VB products including Hospital Indemnity (HI), Accident (AI) & Critical Illness (CI). Primary duties will include conducting thorough investigations to determine eligibility, liability and financial accuracy of all claims received. A key component of this role will also include a focus on providing a service excellence experience that is second to none. What You’ll Do Accountable for managing a caseload of claims that will include all VB products as well as Wellness offerings where appropriate. New claim submissions may be received telephonically, via paper form or digitally. Proactive claims processing may also occur based on customer agreements. Determine eligibility of benefits by reviewing contractual language alongside medical information leading to accurate and timely claims decisions. These decisions should have a focus on overall quality outcomes that deliver a best‑in‑class experience marked by our service excellence approach. Perform multi‑policy checks where appropriate to determine if New York Life claimants with active disability and/or Life claims may be eligible for additional VB benefits as a result of their condition(s) in support of GBS service integration initiatives. Effectively communicate with claimants, employers, and various medical professionals both verbally and in writing to gather information necessary to aid in the claims process. Respond to all telephonic and email inquiries within established customer service protocols while also adhering to standard timeframes. Ensure execution on all customer performance guarantees as defined. Document clear and concise claims notes based on all documentation received/reviewed as well as conversations with the customer, provider, or claimant to support rationale for determinations. Work collaboratively across both the VB claims team as well as the broader GBS claims organization to ensure a cohesive business unit driving to deliver customer value. Adhere daily to New York Life & corporate compliance policies, procedures & best practices. Focus on ongoing development via training associated with the role & business objectives while remaining current on any compliance‑driven training curriculum. Given the newness of the VB product suite, Claims Managers may be asked to aid in validating accuracy and appropriateness of technology builds within the claims system to maximize efficiency. Assume periodic Business Acceptance Testing (BAT) support as system enhancements are delivered. What You’ll Bring High School diploma or GED required. BA/BS degree or equivalent work experience strongly preferred. 2+ years of Group Benefits experience is strongly preferred. Experience administering any GBS claims product (e.g., STD, LTD, FML/PFML, Life/AD&D) preferred. Proficiency with MS Office applications is required (Word, Outlook, Excel). Technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously. Strong critical thinking, analytical and investigative skills with the ability to gather information, analyze facts & draw conclusions. Strong verbal & written communication skills needed to develop comprehensive claims records. Bias for action and a strong focus on service excellence. Effective interpersonal, written and verbal communication skills including the ability to explain complex claim scenarios in easily understandable language for customers and claimants. Pay Transparency Salary range: $45,000–$71,500 Overtime eligible: Nonexempt Discretionary bonus eligible: Yes Sales bonus eligible: No 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. #J-18808-Ljbffr