Short Term Disability Claims Manager

APPLY NOW »

Date: Mar 31, 2021

Location: Pittsburgh, PA, US

Company: New York Life Insurance Co

 

When you join New York Life, you’re joining a company that values development, career growth, collaboration, innovation, and diversity & inclusion. We want employees to feel proud about being part of a company that is committed to doing the right thing. Through various resources and programs, you can grow your career while developing personally and professionally.

GBS2021

 

 

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, Cigna Group Operations and corporate compliance are critical for success.As a Disability Claims Manager, you will:

  • 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 Cigna Group Operations 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

 

Qualifications:

  • 1 year minimum of professional experience strongly preferred
  • HS Diploma or GED required. Bachelor’s degree strongly preferred.
  • Proficiency with MS Office applications is required (Word, Outlook)
  • Proven track record of successfully driving results in a complex matrix environment is a (+)
  • Strong critical, analytical and investigative skills; ability to gather information, analyze facts, and draw conclusions 
  • Additional experience administering FMLA and/or State Leaves is a (+).
  • 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
  • Knowledge of legal liability, insurance coverage and medical terminology is a (+)
  • Must be technically savvy with the ability to toggle between multiple applications and/ or computer monitors simultaneously

 

 

SF:EF-LS1

 

#LI-LS1

 

 

 

 

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 our Foundation. 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.

Job Requisition ID: 83416

 

 

 


Nearest Major Market: Pittsburgh

Job Segment: Claims, Disability, Social Media, Liability, Manager, Human Resources, Insurance, Marketing, Management