Disability and Life Insurance Claims Specialist

Responsibilities

·        Responsible for providing technical and administrative support to the Disability and  Life Insurance claims units of the department

·        Primary responsibility for the administration of the Licensed Practical Nurse ( LPN) Welfare Fund Life and Long Term Disability claims

·        Serve as resource and provide technical guidance to Quality Control Review, Disability and  Life Insurance Claim Processors in the resolution of complex claim situations

·        Maintain a small caseload of disability and life insurance claims

·        Identify trends, report results, and make recommendations regarding training, workflow, management controls, and procedures or system updates

·        Communicate via telephone and in person with members and professionals such as doctors, lawyers, employers as well as employees from other departments of the Fund

·        Prepare monthly reports for senior claims management

·        Perform special projects as assigned by management

 

Qualifications

·        High School Diploma or GED required

·        Minimum four (4) years experience processing disability and life insurance claims, to include a minimum of two (2) years as a Quality Control Reviewer experience required

·        Knowledge of medical claims processing along with member services experience

·        Comprehensive knowledge of National Benefit Funds benefits, programs and policies

·        Good working knowledge of Greater New York, Home Care, LPN Welfare Fund, and Pension Benefits

·        Working knowledge of MS Word and Excel experience

·        Effective written and oral communication skills

·        Ability to handle multiple tasks or projects

·        Problem solver with the ability to work both independently and as team player in a confidential environment

·        Leadership ability along with professional manner and presentation required