Claims Representative, Group Membership Association Division

New York Life Insurance • White Plains, NY

12d • Hybrid

About The Position

The Claims Representative supports the Group Membership Association Division (GMAD) Claims team by ensuring accurate and timely intake, documentation, and setup of insurance claims. The role processes incoming correspondence, maintains claim records, and coordinates with third-party administrators to obtain complete and accurate claim information. Working across multiple claims and imaging systems, the representative helps maintain efficient workflows and supports timely claims processing. The position also provides administrative support to claims examiners and responsive, professional service to members and internal and external partners.

This hybrid position is based in New York Life’s White Plains, New York 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—six onsite days per month in total.

Requirements

• High school diploma or GED.
• Up to 2 years of relevant experience in customer service, administrative support, insurance operations, or a related field.
• Proficiency in Microsoft Word, Excel, PowerPoint, and Access, with the ability to navigate multiple systems and accurately enter and maintain information.
• Strong organizational skills and attention to detail, including the ability to manage multiple priorities, maintain accurate records, and meet daily deadlines.
• Analytical and problem-solving skills, including the ability to review documentation, identify discrepancies, and resolve routine issues using established procedures and guidelines.
• Effective written, verbal, and telephone communication skills, a strong customer service focus, and the ability to collaborate with claimants, administrators, physicians, attorneys, and internal business partners.

Nice To Haves

• Associate's degree.
• 2 or more years of relevant experience in customer service, administrative support, insurance operations, or a related field.
• Familiarity with claims management systems, document imaging platforms, electronic workflows, or records management processes.
• Understanding of disability insurance, supplemental health insurance, or other group insurance products.

Responsibilities

• Process incoming mail, emails, faxes, and scanned documents, ensuring accurate indexing, routing, and organization in claims imaging and workflow systems.
• Establish and maintain new claims across Short Term Disability, Long Term Disability, Office Overhead Expense, Critical Illness, Hospital Indemnity, and Rabies insurance products, including accurate data entry, coding, and timely processing.
• Coordinate with third-party administrators and other stakeholders to obtain required claim forms, verify eligibility documentation, resolve missing information, and support complete and accurate claim submissions.
• Maintain claim forms, assignment records, departmental contact information, and correspondence; assist claims examiners with administrative requests and claims-related activities.
• Communicate professionally with members, claimants, administrators, and other stakeholders, address inquiries, and support timely resolution of routine claims-related issues.

Benefits

• Full package of employee benefits, with offerings that include leave programs, adoption assistance, and student loan repayment programs.
• Eligible for an annual discretionary bonus; may also be eligible to participate in an incentive program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED