Voluntary Benefits Wellness Claims Specialist
New
N
New York LifeInsurance
Georgia, United StatesFull-TimeEntry
Salary$40,000-$52,000
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Job Details
- Experience
- 1+ years of insurance, healthcare, or customer service experience
- Required Skills
- Microsoft ExcelCustomer service
Requirements
- High School diploma or GED required; college coursework or degree preferred.
- 1+ years of experience in insurance, healthcare, or customer service.
- Prior experience in benefits administration or claims preferred.
- Strong attention to detail with the ability to accurately process high volumes of claims.
- Proficiency with Microsoft Office applications including Word, Outlook, and Excel.
- Strong verbal and written communication skills.
- Ability to manage multiple tasks and maintain accuracy in a fast-paced environment.
- Customer-focused mindset with a strong sense of accountability.
- Ability to learn and apply insurance product knowledge, including accident, hospital indemnity, and critical illness benefits.
Responsibilities
- Review and process wellness claims submitted via phone, portal, or mail.
- Verify enrollment, policy provisions, and annual benefit allowances to determine eligibility.
- Document claim decisions accurately and apply appropriate claim benefits per established procedures.
- Handle basic escalations, resolve customer or client concerns, and route complex cases to management.
- Communicate claim outcomes clearly and professionally to customers and business partners.
- Meet productivity and quality standards by achieving daily/weekly adjudication targets.
- Collaborate with peers and managers to identify trends and resolve recurring issues.
- Support special projects, process improvements, and system enhancements.
- Participate in ongoing training to build knowledge and prepare for role progression.
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