Senior Associate, Claims

Location Designation:Hybrid - 6 days per month

Work Schedule and Location: This is a hybrid position based out of our White Plains NY office. Team members are expected to work onsite one day per week (Wednesdays) with one additional onsite day per month for team meetings or business activities.

Business Unit Overview:

As part of New York Lifes Group Membership Association Division youll be working with the nations No. 1 provider of life and disability income insurance solutions for association/affinity programs. Beyond the tailored life and disability income insurance solutions you provide your work fosters a sense of community and shared support within affinity groups.

Role Overview:

The Senior Associate Claims is responsible for evaluating disability claims and determining liability and eligibility for initial and ongoing benefits. This role independently manages a caseload of approximately 125150 claims of varying complexity while ensuring accurate application of policy provisions timely claim management and a high level of customer service. The Senior Associate also adjudicates HIP Office Overhead and Critical Illness claims and works closely with claimants physicians attorneys administrators and other stakeholders to gather information resolve complex issues and support sound claim decisions.

What Youll Do:

• Evaluate initial and ongoing disability claims to determine liability and benefit eligibility accurately interpreting and applying applicable policy provisions to individual claim circumstances.
• Independently manage a caseload of approximately 125150 claims of varying complexity using appropriate resources research and sound judgment to support timely and accurate claim decisions.
• Review address and respond to claim appeals conducting appropriate research and analysis and clearly documenting the rationale for claim decisions.
• Adjudicate HIP Office Overhead and Critical Illness claims identifying and resolving issues through effective research analysis and problem-solving.
• Communicate clearly and professionally with claimants physicians attorneys administrators and other stakeholders providing responsive service and obtaining information needed to effectively manage claims.
• Meet established timeliness standards for communications and claim management activities while maintaining accurate organized and consistent claim handling practices.

What Youll Bring:

Required Skills

• 57 years of disability claims experience with demonstrated ability to evaluate and manage claims of varying complexity
• Strong ability to interpret insurance policy provisions and apply them accurately to individual claim situations
• Strong research analytical and problem-solving skills including the ability to identify and use appropriate resources when managing complex claims
• Strong verbal and written communication and customer service skills with the ability to interact effectively with claimants physicians attorneys administrators and other stakeholders
• Ability to work independently manage a substantial caseload and competing priorities and collaborate effectively in a team environment
• Proficiency with Microsoft Office applications including Word and Excel

Preferred Skills

• Bachelors degree
• Experience adjudicating HIP Office Overhead and Critical Illness claims
• Experience independently managing a high-volume disability claims caseload
• Experience reviewing claim appeals and performing or validating claim calculations

Pay Transparency

Salary Range:$81000-$97000

Overtime eligible:Exempt

Discretionary bonus eligible:Yes

Sales bonus eligible:No

Actual base salary will be determined based on several factors but not limited to individuals experience skills qualifications and job location. Additionally employees are eligible for an annual discretionary 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 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 Lifes leadership in this space.

Recognized as one of Fortunes Worlds Most Admired Companies New York Life is committed to improving local communities through a culture of employee giving and volunteerism supported by the 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 .

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Job Requisition ID: 94583