Accidental Death and Dismemberment Claims Specialist

New York Life Insurance Company; New York (NY); Remote; USD 50,000 - 60,000; Full time

Job summary

A leading insurance company is seeking an Accidental Death and Dismemberment Claims Specialist to effectively manage and process claims. You will play a vital role in determining eligibility and ensuring accurate decisions to support customers through a secure and empathetic approach. The position also highlights the importance of strong communication and organizational skills, alongside a commitment to ethical standards.

Benefits

Comprehensive benefits package

Adoption assistance

Student loan repayment programs

Qualifications

• BA/BS degree or equivalent work experience with focus in Health or Science field desired.
• Forensic Science education and/or background highly desired.
• Demonstrated ability to problem solve, utilize analysis, experience and judgment to make accurate decisions.

Responsibilities

• Conduct claim eligibility determinations and manage on-going claims for benefits.
• Communicate with customers, beneficiaries, business partners, and employers regarding eligibility for benefits.
• Interpret and evaluate death investigation records against applicable contract provisions.

Skills

Problem-solving

Customer service

Planning and organization

Professional communication

Integrity

Education

BA/BS degree or equivalent work experience

Forensic Science education or background

Tools

Microsoft Office applications

Job description

Accidental Death and Dismemberment Claims Specialist

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Accidental Death and Dismemberment Claims Specialist

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Location Designation: Fully Remote

Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of being there when we’re needed most. Here, you'll design, implement, and support these solutions directly impacting employees’ lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.

Location Designation: Fully Remote

Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of being there when we’re needed most. Here, you'll design, implement, and support these solutions directly impacting employees’ lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.

Role Overview

As a Group Claim Associate in the Accidental Death and Dismemberment department, you will partner with medical, legal and other expert resources to research, determine financial liability, and process claims for various products:

• Group Life,
• Group Accidental Death and Dismemberment, and
• Group Business Travel Accident
• Other specialty products
  
  

This includes making determinations regarding eligibility for benefits, providing ongoing claim administration, and communicating decisions and status updates to customers and clients. The Group Claim Associates decisions have a direct impact on customers’ well-being and sense of security. The ability to make and effectively communicate decisions within compliance guidelines, while integrating knowledge of customer contracts, Group Operations and corporate compliance are critical for success.

What You'll Do

• 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 as 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
• Demonstrates solid planning and organizational skills with the ability to address short and long term goals while prioritizing and addressing ongoing issues.
• Consistently drives 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 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.
  
  

What You'll Bring

• BA/BS degree or equivalent work experience with focus in Health or Science field desired
• Forensic Science education and/or background highly desired
• 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
• Proficient in Microsoft Office applications (Word, Outlook)
  
  

Pay Transparency

Salary range: $50,000-$60,000

Overtime eligible: Nonexempt

Discretionary bonus eligible: Yes

Sales bonus eligible: No

Actual base salary will be determined based on several factors but not limited to individual’s experience, skills, qualifications, and job location. Additionally, employees are eligible for an annual discretionary bonus. In addition to base salary, employees may also be eligible to participate in an incentive program.

Actual base salary within that range will be determined by several components including but not limited to the individual's experience, skills, qualifications, and job location. In addition to base salary, employees may also be eligible to participate in an incentive program.

Our Benefits

We provide a full package of benefits for employees – and have unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs. Based on feedback from our employees, we continue to refine and add benefits to our offering, so that you can flourish both inside and outside of work. Click here to discover more about our comprehensive benefit options or visit our NYL Benefits Site.

Our Diversity Promise

We believe in a diverse workforce because it is our mission to advocate for the financial security and success of people in every community. This is why diversity, equity, and inclusion (DEI) are guiding principles that are embedded in our brand and our culture. Click here to learn more about how we have been recognized for our leadership.

Recognized as one of Fortune’s World’s Most Admired Companies, New York Life is committed to improving local communities through a culture of employee giving and volunteerism, supported by the Foundation. We're proud that due to our mutuality, we operate in the best interests of our policy owners. To learn more about career opportunities at New York Life, please visit the Careers page of www.NewYorkLife.com.

Job Requisition ID: 92074

#GBS

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Finance and Sales

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