Senior AD&D Claims Specialist - Remote

New York Life Insurance Co.; Pennsylvania; Remote; USD 48,000 - 55,000; Full time

Job summary

New York Life Insurance Co. seeks an experienced GBS AD&D Claim Senior Representative in the Accidental Death and Dismemberment department. You will research, determine financial liability, and process claims for Group Life, AD&D, and related products in collaboration with medical and legal resources.

You will communicate decisions to customers, ensure timely claim administration, and uphold high ethical standards and compliance while balancing contract terms and company policies.

Qualifications

• BA/BS degree or equivalent work experience in Health or Science.
• Master's degree in Forensic Science and/or 4–7 years of relevant Life or Disability experience preferred.
• Proven problem-solving, analytical judgment, and clear communication.

Responsibilities

• Proactively communicate with customers, beneficiaries, and employers to determine eligibility for benefits.
• Manage complex claims with supervision within established timeframes.
• Interpret death investigations and contract provisions against exclusions and fraud.
• Refer claims to medical/legal resources when appropriate.
• Demonstrate planning and organizational skills to balance short- and long-term goals.
• Complete all required trainings within assigned timeframes.
• Respond to inquiries in a clear, empathetic manner.
• Uphold ethical standards and corporate compliance.

Skills

Problem-solving

Customer service

Team collaboration

Prioritization

Communication skills

Adaptability

Accountability

Decision making

Learning agility

Education

BA/BS degree or equivalent in Health/Science

Master's degree in Forensic Science or related field

Tools

Microsoft Office

Job description

New York Life Insurance Co. seeks an experienced GBS AD&D Claim Senior Representative in the Accidental Death and Dismemberment department. You will research, determine financial liability, and process claims for Group Life, AD&D, and related products in collaboration with medical and legal resources.

You will communicate decisions to customers, ensure timely claim administration, and uphold high ethical standards and compliance while balancing contract terms and company policies.