- Interpret policy/contract language and understand the variances between the different NYL LTC policy forms.
- Review, investigate and document State-specific licensure requirements.
- Review new claims for determination of benefit eligibility.
- Communicate with clients, families, providers in order to process new LTC claims
- Order all necessary medical documentation in order to process a LTC claim
- Prepare and review all outgoing daily departmental correspondence.
- Review and document all State-specific compliance issues pertaining to claims.
- Coordinate materials/information for NYL Actuaries and other departments as needed.
- Respond to inquiries/correspondence from agents, insured’s, providers of service, and third-party vendors.
- Assist Claims Manager in response preparation for State Department of Insurance inquiries or complaints.
- Assist in training of lower-level employees as needed..
- Performs other various duties as required. Job Location TX - Austin Department INS - LONG TERM CARE Position Type Full Time AutoReqId 7465BR Required Qualifications -Ability to meet deadlines and handle multiple tasks simultaneously working well under stress; highly proficient in interpretation and application of contract, and benefit requirements affecting claims processing; detailed knowledge of industry and medical terminology, procedures and standards; Must have a working knowledge of related departments and their functions. Requires excellent verbal and written communication skills and computer skills.
New York Life Insurance has been providing life insurance policies in the Big Apple since it was a tiny seed. While the top mutual life...