Accidental Death and Dismemberment Group Claim Senior Representative

Location Designation: Fully Remote
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 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.
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.• 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).
Competencies:
1. Decision Quality
2. Customer Focus
3. Communicates Effectively
4. Action Oriented
5. Optimizes Work Processes
6. Manages Complexity
It is recommended that all qualified candidates apply to this posting as soon as possible. Residents of Colorado are hereby notified that the deadline to apply is two weeks from the Posting Date listed above.
Pay Transparency
Salary Range: $45,500-$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.
Company Overview
At New York Life, our 180-year legacy of purpose and integrity fuels our future. As we evolve into a more technology-, data-, and AI-enabled organization, we remain grounded in the values that drive lasting impact.
Our diverse business portfolio creates opportunities to make a difference across industries and communities-inviting bold thinking, collaborative problem-solving, and purpose-driven innovation. Here, you'll find the rare balance of long-standing stability and forward momentum, supported by an inclusive team that honors tradition while embracing progress.
As a Fortune 100 mutual company, we offer a place to grow your skills, contribute to meaningful work, and deliver solutions that matter. Your ideas drive what's next, and your growth powers it.
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 hereto discover more about our comprehensive benefit options or visit our NYL Benefits Site.
Our Commitment to Inclusion
At New York Life, fostering an inclusive workplace is fundamental to who we are and how we serve our communities. We have a longstanding commitment to creating an environment where individuals can contribute their best and succeed together. This foundation is rooted in our core values of humanity and integrity, ensuring that every employee feels valued and supported. By embracing a broad range of perspectives and experiences, we achieve greater success and fulfill our promise of providing financial security and peace of mind to families across all communities. Click here to learn more about New York Life's leadership in this space.
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.
Visit our LinkedIn to see how our employees and agents are leading the industry and impacting communities.
Visit our Newsroom to learn more about how our company is constantly evolving to meet our clients' and employees' needs.
Job Requisition ID: 93716