About this role
Role Overview
- The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims.
- Researches specifics regarding eligibility and pre-existing formulas in reference to specific claim.
- Fully investigates all relevant claim issues with oversight by Manager when needed.
- Provides payment or denials promptly and in full compliance with department procedures and regulations.
- Pro-actively communicates with claimants, policyholders, and physicians when applicable.
- Manages assigned case load and processes within the specified time requirements.
- Provides customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.
- Establishes, communicates, and manages claimant and policyholder expectations.
- Documents claim file actions and telephone conversations appropriately.
- Ability to handle confidential information with the utmost judgment and discretion.
Requirements
- High school diploma (or equivalent)
- Must have 1-3 years of New York State statutory Disability and Paid Family leave claims processing experience to be considered for this role.
- Experience with Microsoft Office
- Work experience in decision-making and information analysis.
- Demonstrated prioritization and organization skills.
- Ability to communicate clearly and succinctly verbally and in writing
- Must be able to work in a team oriented environment.
- Meet and exceed production, attendance, quality and service
- Ability to organize work, manage time and follow through
- Availability to work overtime when required
- Ability to Travel: None
Benefits
- An annual performance bonus for all team members
- Generous 401(k) company match that is immediately vested
- A choice of three medical plans (that include prescription drug coverage) to suit your unique needs.
- For High Deductible Health Plan enrollees, a company contribution to your Health Savings Account
- Multiple options for dental and vision coverage
- Company provided Life & Disability Insurance to ensure financial protection when you need it most
- Family friendly benefits including Paid Parental Leave & Adoption Assistance
- Hybrid work arrangements for eligible roles
- Tuition Reimbursement and Continuing Professional Education
- Paid Time Off – new hires start with at least 20 days of PTO per year in addition to nine company paid holidays.
- As you grow with us, your PTO may increase based on your level within the company and years of service.
- Volunteer days, community partnerships, and Employee Assistance Program
- Ability to connect with colleagues around the country through our Employee Resource Group program