Group Life Claims Representative

 

Location Designation: Fully Remote 

 

 

Role Overview: 

 

As a Group Life Claims Representative, you will develop the skills needed to conduct Life Insurance claim investigations, make determinations regarding eligibility for benefits, provide ongoing claim administration, and communicate decisions and status updates.  This role will manage a high volume, and attention to detail is important. The Group Claim Representative decisions have a direct impact on customers’ well-being and sense of security.  The ability to make and effectively communicate decisions within compliance guidelines, while integrating knowledge of customer contracts, GBS Group Operations and corporate compliance are critical for success. 

 

What You'll Do: 

 

• Complete life claim customer eligibility determinations and manage on-going claims through, applying appropriate contractual provisions, following legal guidelines, and working closely with technical leadership.
• Respond to calls from customers and clients, responding to inquiries proactively and empathically regarding life benefits
• Communicate with customers, beneficiaries, business partners, and employers, to gather information regarding assessing eligibility and ongoing management of benefits.
• With close supervision, respond to written and telephone inquiries from customers, including eligibility, approval/denial determinations, status and continuation or closure of benefits.
• Pay all covered claims up to $60,000.00 accurately and efficiently with minimal supervision
• Refer claims to Expert Resources with guidance from Technical leadership
• Learn to identify medical records needed to assist with claim reviews
• Execute on all customer performance guarantees          
• Adhere to standard timeframes for processing mail, tasks and outliers
• Understand Group Benefit Solutions (GBS) and Corporate Compliance, Policies and Procedures and best practices  
• Complete all GBS and NYL required trainings within designated deadlines
• Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner

 

What You'll Bring: 

• HS Diploma or GED required. Bachelor’s degree strongly preferred OR 2+ years equivalent work experience
• Proficiency with MS Office applications is required (Word, Outlook)
• Proven track record of successfully driving results in a complex matrix environment is a plus
• Ability to gather information, analyze facts, and draw conclusions
• Works with a sense of urgency and is a self-starter with a customer focus mindset
• Ability to build and maintain effective relationships
• Effective interpersonal, written and verbal communication skills
• Excellent planning, time management and organizational skills
• Ability to manage multiple and changing priorities.
• Knowledge of legal liability, insurance coverage and medical terminology is a plus

 

Core Competencies:
1. Decision Quality
2. Customer Focus
3. Effective Communication
4. Action Oriented

 

Pay Transparency

Salary Range: $45,000-$55,000 

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. <