Byrne Dairy
Sr. Disability and Leave Management Claims Examiner- Group Insurance Claims Expe
Byrne Dairy, Syracuse, New York, United States
Primary Location
UNITED STATES-Remote
Other Locations UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse
Organization Equitable
Schedule Full-time
Description At Equitable, our power is in our people.
We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?
Equitable is looking for an experienced Claims Specialist supporting Disability and Leave Management claims to join our team! The Claims Specialist is responsible for providing excellent customer service. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions and partner with internal and external resources. Reliability and dependability through our extensive training program is required.
Key Job Responsibilities
Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved
Communication via telephone, email, and text with employees, employers, attorneys, and others
Review and interpret medical records, utilizing resources as appropriate
Complete financial calculations
Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication
Apply contract/policy provisions to ensure accurate eligibility and liability decisions
Demonstrate and apply analytical and critical thinking skills
Verify on-going liability and develop strategies for return-to-work opportunities as appropriate
Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication
Leverage a broad spectrum of resources, materials, and tools to render claims decisions
Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards
Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities
Work independently as well as within a team structure
Deliver refresher trainings as appropriate to the claim team
Identify areas for improvement in claims processing, including workflow changes or improving procedure based on trends or challenges observed in claim review.
Prepare reports for management on claim outcomes and performance metrics.
Assist in training and mentoring junior claim examiners on best practices, improving their decision-making skills.
Oversee the ongoing management of complex, high-priority or escalated cases and callers.
The base salary range for this position is $60,000 - $65,000. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below.
Equitable Pay and Benefits Equitable Total Rewards Program
Qualifications Required Qualifications
Bachelor’s degree or equivalent work experience
3+ disability claims administration experience
Prior leadership experience as a team lead or manager
Exceptional customer service skills
Maintains positive and effective interaction with challenging customers
Strong knowledge of disability and leave laws and regulations
Ability to handle sensitive information with confidentiality and professionalism
Group Disability Claims experience
Prior experience managing Paid Family Leave for multiple state
Preferred Qualifications
Experience working with the Fineos Claim Management System
Exceptional written and oral communication skills demonstrated in previous work experience
Excellent organizational and time management skills with ability to multitask and prioritize deadlines
Ability to manage multiple and changing priorities
Detail oriented; able to analyze and research contract information
Demonstrated ability to operate with a sense of urgency
Experience in effectively meeting/ exceeding individual professional expectations and team goals
Demonstrated analytical and math skills
Ability to exercise critical thinking skills, risk management skills and sound judgment
Ability to adapt, problem solve quickly and communicate effective solutions
High level of flexibility to adapt to the changing needs of the organization
Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment
Continuous improvement mindset
A commitment to support a work environment that fosters diversity and inclusion.
Proficiency in computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word
Skills Analytical Thinking:
Knowledge of techniques and tools that promote effective analysis; ability to determine the root cause of organizational problems and create alternative solutions that resolve these problems.
Customer Support Operations:
Knowledge of customer support techniques, tools, technologies, and best practices; ability to utilize all aspects of customer support operations to manage a call center.
Customer Support Systems:
Knowledge of principles and techniques used in customer support and ability to use applications, hardware, software, networking, and the applications environment used for customer support.
Managing Multiple Priorities:
Knowledge of effective self-management practices; ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation.
Problem Solving:
Knowledge of approaches, tools, techniques for recognizing anticipating, and resolving organizational, operational or process problems; ability to apply knowledge of problem solving appropriately to diverse situations.
About Equitable At Equitable, we’re a team committed to helping our clients secure their financial well-being so that they can pursue long and fulfilling lives.
We turn challenges into opportunities by thinking, working, and leading differently – where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth, internal mobility, comprehensive compensation and benefits to support overall well-being, flexibility, and a culture of collaboration and teamwork.
We are looking for talented, dedicated, purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
Equitable is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national origin, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws.
NOTE: Equitable participates in the E-Verify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position, please contact Human Resources at 212-314-2211 or email us at TalentAcquisition@equitable.com.
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Other Locations UNITED STATES-NC-Charlotte, UNITED STATES-NY-Syracuse
Organization Equitable
Schedule Full-time
Description At Equitable, our power is in our people.
We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your potential?
Equitable is looking for an experienced Claims Specialist supporting Disability and Leave Management claims to join our team! The Claims Specialist is responsible for providing excellent customer service. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions and partner with internal and external resources. Reliability and dependability through our extensive training program is required.
Key Job Responsibilities
Deliver an exceptional customer experience and ensure that customer commitments and deliverables are achieved
Communication via telephone, email, and text with employees, employers, attorneys, and others
Review and interpret medical records, utilizing resources as appropriate
Complete financial calculations
Gain an understanding and working knowledge of the Equitable claim and other applicable systems, policies, procedures, and contracts as well as regulatory and statutory requirements for claim adjudication
Apply contract/policy provisions to ensure accurate eligibility and liability decisions
Demonstrate and apply analytical and critical thinking skills
Verify on-going liability and develop strategies for return-to-work opportunities as appropriate
Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication
Leverage a broad spectrum of resources, materials, and tools to render claims decisions
Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards
Work within a fast-paced environment, with tight deadlines, and demonstrate the ability to balance multiple priorities
Work independently as well as within a team structure
Deliver refresher trainings as appropriate to the claim team
Identify areas for improvement in claims processing, including workflow changes or improving procedure based on trends or challenges observed in claim review.
Prepare reports for management on claim outcomes and performance metrics.
Assist in training and mentoring junior claim examiners on best practices, improving their decision-making skills.
Oversee the ongoing management of complex, high-priority or escalated cases and callers.
The base salary range for this position is $60,000 - $65,000. Actual base salaries vary based on skills, experience, and geographical location. In addition to base pay, Equitable provides compensation to reward performance with base salary increases, spot bonuses, and short-term incentive compensation opportunities. Eligibility for these programs depends on level and functional area of responsibility.
For eligible employees, Equitable provides a full range of benefits. This includes medical, dental, vision, a 401(k) plan, and paid time off. For detailed descriptions of these benefits, please reference the link below.
Equitable Pay and Benefits Equitable Total Rewards Program
Qualifications Required Qualifications
Bachelor’s degree or equivalent work experience
3+ disability claims administration experience
Prior leadership experience as a team lead or manager
Exceptional customer service skills
Maintains positive and effective interaction with challenging customers
Strong knowledge of disability and leave laws and regulations
Ability to handle sensitive information with confidentiality and professionalism
Group Disability Claims experience
Prior experience managing Paid Family Leave for multiple state
Preferred Qualifications
Experience working with the Fineos Claim Management System
Exceptional written and oral communication skills demonstrated in previous work experience
Excellent organizational and time management skills with ability to multitask and prioritize deadlines
Ability to manage multiple and changing priorities
Detail oriented; able to analyze and research contract information
Demonstrated ability to operate with a sense of urgency
Experience in effectively meeting/ exceeding individual professional expectations and team goals
Demonstrated analytical and math skills
Ability to exercise critical thinking skills, risk management skills and sound judgment
Ability to adapt, problem solve quickly and communicate effective solutions
High level of flexibility to adapt to the changing needs of the organization
Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment
Continuous improvement mindset
A commitment to support a work environment that fosters diversity and inclusion.
Proficiency in computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word
Skills Analytical Thinking:
Knowledge of techniques and tools that promote effective analysis; ability to determine the root cause of organizational problems and create alternative solutions that resolve these problems.
Customer Support Operations:
Knowledge of customer support techniques, tools, technologies, and best practices; ability to utilize all aspects of customer support operations to manage a call center.
Customer Support Systems:
Knowledge of principles and techniques used in customer support and ability to use applications, hardware, software, networking, and the applications environment used for customer support.
Managing Multiple Priorities:
Knowledge of effective self-management practices; ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgments as to prioritizing and time allocation.
Problem Solving:
Knowledge of approaches, tools, techniques for recognizing anticipating, and resolving organizational, operational or process problems; ability to apply knowledge of problem solving appropriately to diverse situations.
About Equitable At Equitable, we’re a team committed to helping our clients secure their financial well-being so that they can pursue long and fulfilling lives.
We turn challenges into opportunities by thinking, working, and leading differently – where everyone is a leader. We encourage every employee to leverage their unique talents to become a force for good at Equitable and in their local communities.
We are continuously investing in our people by offering growth, internal mobility, comprehensive compensation and benefits to support overall well-being, flexibility, and a culture of collaboration and teamwork.
We are looking for talented, dedicated, purposeful people who want to make an impact. Join Equitable and pursue a career with purpose.
Equitable is committed to providing equal employment opportunities to our employees, applicants and candidates based on individual qualifications, without regard to race, color, religion, gender, gender identity and expression, age, national origin, mental or physical disabilities, sexual orientation, veteran status, genetic information or any other class protected by federal, state and local laws.
NOTE: Equitable participates in the E-Verify program.
If reasonable accommodation is needed to participate in the job application or interview process or to perform the essential job functions of this position, please contact Human Resources at 212-314-2211 or email us at TalentAcquisition@equitable.com.
#J-18808-Ljbffr