Senior Associate - Contestable Claims - New York - 10007
New York Life
Financial Services - Insurance
21 Warren St
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A career at New York Life offers many opportunities. To be part of a growing and successful business. To reach your full potential, whatever your specialty. Above all, to make a difference in the world by helping people achieve financial security. It's a career journey you can be proud of, and you'll find plenty of support along the way. Our development programs range from skill-building to management training, and we value our diverse and inclusive workplace where all voices can be heard. 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 service, supported by our Foundation. It all adds up to a rewarding career at a company where doing right by our customers is part of who we are, as a mutual company without outside shareholders. We invite you to bring your talents to New York Life, so we can continue to help families and businesses \"Be Good At Life.\" To learn more, please visit LinkedIn, our Newsroom and the Careers page of www.NewYorkLife.com.
The Senior Claims Associate handles processing of contestable death claims (claims within the 2 year contestability period) and will be required to recommend payment approval or claim denial to a Claims Officer. The Associate will adjudicate foreign and high-dollar death claims (+$2.5M) with minimal oversight. They will initiate and oversee claim investigations with beneficiaries, family members, doctors, attorneys, agents and vendors to make informed claims decisions. Although there are guidelines to assist with processing claims, the Associate will also need to utilize past experiences as well as best practices to independently make and recommend sound claims decisions. They must adhere to Fair Claims Practices, regulations, NYL Claims service standards, Delegation of Authority and Corporate policies. The Associate with report directly to an Officer within our Claims team and will work closely with internal and external counsel, underwriting and senior management.
* Conduct claim investigations with beneficiaries, family members, doctors, attorneys, agents and vendors. Gather the necessary information and work with appropriate internal and outside experts to effectively evaluate large dollar, foreign and contestable claims. * Recommend payment approval or claim denial within given authority level to $1M and provide sound claims decisions for amounts above their authority on contestable claims. Take ownership of complex cases and escalate to management as appropriate. * Accurately adjudicate foreign and high-dollar death claims (+2.5M) with minimal oversight. * Provide a high level of customer care in every interaction. Advise beneficiaries or their representatives verbally and/or in writing of the policy/plan provisions, necessary documentation and claim status. * Prepare well written communications to beneficiaries/representatives, internal and external counsel, underwriting and senior management. * Manage a queue of assigned claims adhering to Fair Claims Practices, Regulations, NYL Claims Service Standards, Delegation of Authority and Corporate Policies.
* Must have 5-10 years Claims experience through formal training or considerable on the job experience * Bachelor's Degree required * Comprehensive knowledge of claims procedures, investigative techniques and related legal principles including underwriting rules where applicable * Strong PC skills to include Word, Excel, Outlook with the ability to navigate multiple applications during call handling * Proven ability to work in a fast paced environment with attention to detail as individual will be handling inbound phone calls and multi-tasking navigation through numerous applications * Must have excellent verbal and listening skills, be detail oriented and have the desire and ability to provide customer service in a professional positive manner while maintaining an empathic voice with the beneficiary/agent * Strong accountability and customer service skills to provide exceptional service * Strong problem-solving skills * Excellent soft skills with professional demeanor for all interactions with clients and agents * Continuous improvement mindset * Ability to use negotiation and facilitation skills when dealing with highly sensitive customer situations
Please note: This role requires FINRA licensed and/or FINRA Associated Person pre-hire fingerprinting.
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