Claims Associate - Family Medical Leave

APPLY NOW »

Date: Feb 10, 2021

Location: Pittsburgh, PA, US

Company: New York Life Insurance Co

A career at New York Life offers many opportunities. To be part of a growing and successful business. To reach your full potential, whatever your specialty. Above all, to make a difference in the world by helping people achieve financial security. It’s a career journey you can be proud of, and you’ll find plenty of support along the way. Our development programs range from skill-building to management training, and we value our diverse and inclusive workplace where all voices can be heard. 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 service, supported by our Foundation. It all adds up to a rewarding career at a company where doing right by our customers is part of who we are, as a mutual company without outside shareholders. We invite you to bring your talents to New York Life, so we can continue to help families and businesses “Be Good At Life.” To learn more, please visit LinkedIn, our Newsroom and the Careers page of www.NewYorkLife.com.

 

Alternate locations: Minneapolis, MN (Minnesota); Plano, TX (Texas)

 

Group Claims Associate Leave Manager – Family Medical Leave

 

 

The Group Claims Associate will work on a team of 12-15 and is responsible for managing assigned caseload of FML and/or ADA leaves. This role is responsible to review leave policy information, be proficient in the federal/state regulations and review medical certifications. This role will partner with Short Term Disability on concurrent leaves of absence for optimal outcomes. 

 

Responsibilities:

  • Manage all absence requests within appropriate service metrics
  • Respond to all customer inquiries within time standards
  • Conduct an evaluation of all absences, including a review of all medical information, and determine whether to approve or deny
  • Obtain a medical review from a Nurse Case Manager when necessary
  • Identify when additional information is required to make a decision on an absence request and gather the information
  • Provide all necessary communication to all parties including employees, policyholders, health care providers and other internal team members
  • Meet all service & performance metrics and expectations
  • Adhere to all legal/compliance requirements.
  • Maintain FMLA and absence information in the system, including comprehensive activity notes
  • Identify escalated cases and develop a plan to address key issues

 

Qualifications:

  • High School Diploma or equivalent required. BA degree preferred.
  • Prior customer service or call center related work experience required
  • Prior FMLA or Disability Claims experience (preferred)
  • Customer Focus
  • Time Management Skills
  • Drive for Results
  • Functional/Technical Skills
  • Learning on the Fly
  • Peer Relationships
  • Problem Solving
  • Communication Skills

 

 

#LI-JM1

EOE M/F/D/V

 

If you have difficulty using or interacting with any portions of this Web site due to incompatibility with an Assistive Technology, if you need the information in an alternative format, or if you have suggestions on how we can make this site more accessible, please contact us at: (212) 576-5811.

Job Requisition ID: 83241 


Nearest Major Market: Pittsburgh

Job Segment: Claims, Social Media, Call Center, Insurance, Marketing, Customer Service