出海雷达

高级代表,意外死亡与残害保险

Senior Representative, Accidental Death and Dismemberment

其他限定地区(需当地身份)
公司New York Life Insurance Co
薪资$45,000 - $60,000/年
工作地点United States
地域资格限定地区(需当地身份)
时区要求日间重叠约 9 小时,基本正常作息
用工类型Full Time
发布时间17 天前
数据来源Himalayas
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注意地域限制:该职位明确限定在 United States 招聘。如果你是位于中国大陆的求职者,通常需要当地工作身份才能投递,或需与雇主确认是否接受独立合同(Contractor)形式合作。

职位描述:全远程办公
Group Benefit Solutions 为中型和大型公司提供全面的保险和缺勤管理解决方案。我们的工作有助于打造更健康、更幸福、更安全的员工队伍,为纽约人寿在我们需要的时候挺身而出的声誉做出贡献。在这里,你将直接参与设计、实施和支持这些直接影响员工生活的解决方案。我们核心业务是通过缺勤、意外、残疾、自愿福利和人寿保险解决方案,为人们提供财务保障和安心。点击此处了解有关团体福利解决方案的更多信息。

职位概述:
作为意外伤害与身故部门的AD&D索赔高级代表,你将与医疗、法律和其他专家资源合作,研究、确定财务责任并处理团体人寿、意外身故与残废、团体商务旅行意外及其他特殊产品的索赔。这包括确定受益资格,提供持续的索赔管理,并向客户和客户传达决定和状态更新。你对客户的福祉和安全感有直接影响。在合规指南内做出并有效传达决策,同时整合客户合同、团体运营和公司合规知识,是成功的关键。

主要职责:

  • 独立进行索赔资格认定,并通过应用适当的合同条款并遵循法律指南来管理持续的索赔。
  • • 主动与客户、受益人、业务合作伙伴和雇主沟通,以获取有关受益资格的信息。
  • • 在最少监督的情况下管理复杂索赔,并在需要时识别是否需要技术专家和/或团队主管的帮助。
  • • 根据适用的合同条款(包括排除条款、限制、重大误述和欺诈)解读和评估死亡调查记录(警方、尸检、毒理学、法医调查报告、外国文件、医疗记录等)。
  • • 在适当情况下独立将索赔转交医疗、法律和其他专家资源。
  • • 展现出扎实的规划和组织能力,能够应对短期和长期目标,同时优先处理并解决持续的问题。
  • • 持续推动项目/工作的成功实施
查看英文原文

Location Designation: Fully Remote
Group Benefit Solutions deliverscomprehensive insurance and absence management solutions for mid-sized and large companies. Our work fosters a healthier, happier, and more secure workforce, contributing to New York Life’s legacy of beingthere when we’re needed most. Here, you'll design, implement, and support these solutions directly impacting employees’ lives. At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions. Click here to learn more about Group Benefits solutions.
Role Overview:
As an AD&D Claims Senior Representative in the Accidental Death and Dismemberment department, you will partner with medical, legal and other expert resources to research, determine financial liability, and process claims for Group Life, Accidental Death and Dismemberment, Group Business Travel Accident and other specialty products. This includes making determinations regarding eligibility for benefits, providing ongoing claim administration, and communicating decisions and status updates to customers and clients.You 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, Group Operations and corporate compliance are critical for success.
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 departmental 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: $45,000-$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.
Actual base salary within that range will be determined by several components including but not limited to the individual's experience, skills, qualifications, and job location.In 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 hereto discover more about our comprehensive benefit options or visit ourNYL Benefits Site.
Our Diversity Promise
We believe in a diverse workforce because it is our mission to advocate for the financial security and success of people in every community. This is why diversity, equity, and inclusion (DEI) are guiding principles that are embedded in our brand and our culture. Click here to learn more about how we have been recognized for our leadership.
Recognized as one ofFortune’sWorld’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 .
​Job Requisition ID: 94405
#GBS
Originally posted on Himalayas

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