- 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 - 18 months ago
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...