New York Life Insurance Company · 1 week ago
Accidental Death and Dismemberment Group Claim Sr Representative
United States
Full-time
Remote
Mid, Senior Level
$46K/yr - $60K/yrNew York Life Insurance Company is seeking a Senior Representative for their Accidental Death and Dismemberment Group Claims. The role involves managing claims, determining eligibility, and communicating with customers while ensuring compliance with legal guidelines.
FinanceFinancial ServicesInsurance
Responsibilities
Independently conduct claim eligibility determinations and manage on-going claims for benefits through applying appropriate contractual provisions and following legal guidelines
Proactively communicate with customers, beneficiaries, business partners, and employers, to gather information regarding eligibility for benefits
Manage complex claims with minimal supervision, and recognize when assistance from Technical Specialist and/or Team Leader is needed
Interpret and evaluate death investigation records (police, autopsy, toxicology, forensic investigative reports, foreign documents, medical records, etc.) against the applicable contract provisions including exclusions, limitations, material misrepresentations and fraud
Independently refer claims to medical, legal and other Expert Resources when appropriate
Demonstrate solid planning and organizational skills with the ability to address short and long term goals while prioritizing and addressing ongoing issues
Consistently drive initiatives/efforts to successful and compliant outcomes
Provide coaching to other employees as needed
Complete all GBS and NYL required trainings within assigned timeframes
Independently respond to high levels of call volume or other communications from customers and clients. Respond to all telephonic and email inquiries within customer service protocols in a clear, concise, empathetic and timely manner
Embodies company’s commitment to high ethical and fair claim standards, corporate compliance, Policies and Procedures and best practices with employees
Qualification
Required
BA/BS degree or equivalent work experience with focus in Health or Science field desired
Forensic Science education and/or background highly desired
Strong investigative skills; ability to gather information, analyze facts, and draw conclusions; demonstrated ability to problem solve, utilize analysis, experience and judgment to make accurate decisions
Clear and concise and timely professional communications using all mediums
Experience in delivering exceptional customer service
Team oriented focus with ability to perform at the highest level
Ability to prioritize critical objectives focusing on high impact components
Maintains professionalism and flexibility despite conflicting demands
Executes decisiveness even when dealing with ambiguity
Ability to learn process and product information and adapt quickly and effectively
Integrity, objectivity and personal accountability for own decisions and honors both internal and external commitments
Accepts challenges and demonstrates accountability for own developmental opportunities
Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously
Proficient in Microsoft Office applications (Word, Outlook)
Benefits
Leave programs
Adoption assistance
Student loan repayment programs
Company
New York Life Insurance Company
For over 180 years, we’ve helped turn your biggest dreams into milestones that last a lifetime.
Founded in 1845
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Don Vu
Senior Vice President, Chief Data & Analytics Officer
Deepa Soni
Executive Vice President and Chief Information Officer
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