Claims Representative, Group Membership Association Division

Business Unit

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

What You'll Do

• Manage claims intake and documentation by processing incoming mail, emails, faxes, and scanned documents, ensuring accurate indexing, routing, and organization within claims imaging and workflow systems.
• Establish and maintain new claims across multiple insurance products, including Short Term Disability, Long Term Disability, Office Overhead Expense, Critical Illness, Hospital Indemnity, and Rabies, ensuring 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.
• Support daily claims operations by maintaining claim forms, assignment records, departmental contact information, and correspondence while assisting claims examiners with administrative requests and claims-related activities.
• Deliver responsive customer service by communicating professionally with members, claimants, administrators, and other stakeholders, addressing inquiries, and supporting timely resolution of routine claims-related issues.

What You'll Bring

Required Skills

• 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 Office applications, including 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, with 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, with a strong customer service focus and the ability to collaborate with claimants, administrators, physicians, attorneys, and internal business partners.

Preferred Skills

• 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.