Remote Life Claims Specialist - Eligibility & Benefits

New York Life Insurance Co.; Watertown (CT); Remote; USD 50,000 - 55,000; Full time

Benefits offered by this job

Adoption assistance

Student loan repayment programs

Leave programs

Job summary

New York Life Insurance Co. is seeking a Life Claims Specialist to join Group Benefit Solutions. You will develop skills to conduct life insurance claim investigations, determine eligibility, administer ongoing claims, and clearly communicate decisions to customers.

The role demands high accuracy and strict adherence to compliance in a high-volume environment. You will coordinate with customers, beneficiaries, employers and partners to gather information, assess eligibility, and manage benefits

Qualifications

• One year minimum of professional experience preferred.
• HS Diploma or GED required; Bachelor's degree strongly preferred.
• Proficiency with MS Office applications (Word, Outlook, PowerPoint, Teams, Excel, SharePoint).
• Proven track record of driving results in a complex matrix environment.
• Ability to gather information, analyze facts, and draw conclusions.
• Works with urgency and a customer focus mindset.
• Strong interpersonal, written and verbal communication skills.
• Excellent planning, time management and organizational skills.
• Ability to manage multiple changing priorities.
• Knowledge of legal liability, insurance coverage and medical terminology is a plus.

Responsibilities

• Complete life claim eligibility determinations and manage ongoing claims.
• Respond to high call volumes and inquiries regarding life benefits.
• Communicate with customers, beneficiaries, partners, and employers to gather information.
• Respond to inquiries on eligibility, approvals/denials, status and continuation of benefits.
• Pay all covered claims up to $60,000 accurately and efficiently.
• Refer claims to Expert Resources with guidance from leadership.
• Learn to identify medical records needed for claim reviews.
• Adhere to customer service protocols and deadlines.

Skills

Analytical thinking

Communication skills

Customer focus

Time management

Relationship building

Negotiation skills

Education

HS Diploma or GED

Bachelor’s degree

Tools

MS Office Suite

Job description

New York Life Insurance Co. is seeking a Life Claims Specialist to join Group Benefit Solutions. You will develop skills to conduct life insurance claim investigations, determine eligibility, administer ongoing claims, and clearly communicate decisions to customers.

The role demands high accuracy and strict adherence to compliance in a high-volume environment. You will coordinate with customers, beneficiaries, employers and partners to gather information, assess eligibility, and manage benefits