Claims Associate

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 Life’s Group Membership Association Division, you'll be working with the nation’s 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 125–150 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 You\'ll 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 125–150 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 You\'ll Bring Required Skills 5–7 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 Bachelor’s 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: $81,000-$97,000 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 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 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 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 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: 94583 #J-18808-Ljbffr