SENIOR ASSOCIATE - Group Claims - Accidental Death & Dismemberment


Date: Feb 16, 2021

Location: Pittsburgh, PA, US

Company: New York Life Insurance Co

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



This position is the senior, non-management technical resource within the Accidental Death and Dismemberment claim team. It is responsible for the providing a high level of technical claim expertise including mentoring the group’s Claim Specialists, individual claim file reviews, complex claim adjudication and technical interfaces with Claim and other business partners.



  • Provides support to Claim Manager in resolving technical issues and questions surfaced during the processing of claims for multiple product lines including claim decisions, appeals, referrals and complaint resolution
  • Supports the in-house quality review process for adjudication accuracy and quality, providing feedback to Team Leader and Claim Managers
  • Maintains an assigned desk load, including a mix of complex claims that requires expert technical or customer service support
  • Supports the call coaching process and assumes principal responsibility for call coaching as needed
  • Works with the training staff to deliver needed training and may lead a portion of the training
  • Works with Underwriting, Sales and Training Departments to educate Claim Manager on new products, new product features and amendments
  • Works in conjunction with internal business partners to address needs for client presentations, implementation and any claim service issues
  • Works with Legal Department and/or Customer Service staff on claim referrals, prospective or in-progress claim litigation, training and procedural documentation, quality/process improvement and compliance initiatives
  • Demonstrates solid planning and organizational skills with the ability to address short and long term goals while prioritizing and addressing ongoing issues
  • Consistently drives initiatives/efforts to successful and compliant outcomes
  • Embodies company’s commitment to high ethical and fair claim standards, corporate compliance, Policies and Procedures and best practices with employees 


Preferred Qualifications:

  • Technical acumen of Group Insurance industry
  • Clear and concise professional communication using all mediums
  • BA/BS degree or equivalent work experience, with focus in Health or Science field desired
  • Forensic Science education and/or background highly desired 
  • Strong analytical skills and ability to comprehend and clarify complex and ambiguous concepts
  • Minimum of 3 years Accident claim management experience
  • Previous technical experience directing or coaching others 
  • Maintains professionalism and flexibility despite conflicting demands
  • Excellent interpersonal, organizational and critical thinking skillset
  • Integrity, objectivity and personal accountability



Communicates Effectively

Manages Ambiguity

Decision Quality

Situational Adaptability

Drives Results



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Job Requisition ID: 83232 

Nearest Major Market: Pittsburgh

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