FACT Sr. Specialist

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:
The FACT Sr. Specialist plays an important role in ensuring accurate financial processing and communication within the claims lifecycle. This position is responsible for evaluating and executing routine financial transactions, coordinating with internal and external customers, and maintaining clear documentation to support claims integrity and policy compliance. The ideal candidate is detail-oriented, proactive in communication, and comfortable working in a deadline-driven environment.
What You'll Do:
• Ownership of accuracy in financial coding and calculations for routine claim transactions.
• SSDI awards and any resulting overpayments• Non-complex Basic Monthly earnings calculations• Non-complex Return to Work earnings calculations• Routine offset coding
• Overpayment recoveries
• Engage directly with claimants to initiate repayment discussions, both ongoing and closed claims, to establish repayment plans.• Work with third-party vendors (e.g., SSDI and subrogation vendors) to coordinate calculation reviews and manage financial recovery efforts related to workers' compensation, motor vehicle accidents (MVAs), and third-party liability.• Support reviews of claimant bankruptcy filings and assess impact on recovery efforts and financial processing.
• Create and deliver clear written and verbal communications to claimants regarding offset placements, overpayments, and repayment arrangements.• Identify potential financial discrepancies and escalate issues to Technical Associates for further review and resolution.• Maintain complete and accurate documentation of financial decisions and correspondence in claim files to ensure clear understanding by any reviewer.• Apply relevant claim policies, procedures, and provisions during all stages of review and processing to ensure compliance and consistency.• Identification of automation and reporting improvements, with a focus on AI tools.• Other Duties as Assigned
What You'll Bring:• Associate degree or above preferred.• 2+ years of experience in disability claims, insurance operations, or financial processing.• Understanding of basic financial concepts including benefit calculations, overpayments, and offsets.• Strong attention to detail and accuracy.• Strong communication skills (written and verbal), with a customer-centric approach.• Strong focus on continuous improvement.• Ability to manage sensitive or confidential information with professionalism and discretion.• Experience with financial or claims systems (e.g., policy administration, workflow tools) a plus.• Comfortable working collaboratively in a fast-paced environment.• Strong time management and organizational skills.
Preferred Skills:• Insurance Industry designation (Associate, Customer Service (ACS), Fellow, Life Management Institute (FLMI), etc.).• Experience with disability insurance products.• Experience with Admin Suite.• Familiarity with AI tools.• Familiarity with SSDI processes, subrogation, and insurance recovery practices.• Familiarity with payroll and W-2 reporting.• Proficiency in Microsoft Office Suite (Excel, Outlook, Word).• Accounting/bookkeeping experience.• Experience with receivable collections.
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.
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Pay Transparency
Salary range: $57,000-$81,500
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 our NYL 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 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 www.NewYorkLife.com.
Job Requisition ID: 92784
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