Group Claim Associate Analyst

Location Designation:
Fully Remote

Group Benefit Solutions delivers comprehensive 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 being there 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.  

to learn more about Group Benefits solutions.

As a Group Claim Associate Analyst, you will develop the knowledge and skills needed to complete a disability investigation for Life Waiver of Premium benefits. This will include reviewing medical documentation in LTD and Waiver claims, providing ongoing claim administration, evaluating any occupation eligibility, and communicating decisions and status updates to customers and clients. The ability to manage changing volumes and pay close attention to detail will lead to success in this role.

The Group Claim Associate Analyst’s decisions 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, GBS Group Operations and corporate compliance are critical for success.

• Conduct Waiver of Premium claim disability determinations, and manage on-going claims for benefits through applying appropriate contractual provisions, determining appropriate follow up points for medical information following medical recommendations, and working closely with Technical leadership as needed.
• Partner closely with LTD analyst, Medical, and Vocational Experts for assistance with evaluating complex medical information
• Communicate with customers, business partners, and employers, to gather information regarding assessing eligibility and ongoing management of benefits.
• With minimum supervision, respond to calls from customers and clients. Respond to various written and telephone inquiries, including eligibility, approval/denial determinations, status and continuation or closure of benefits.
• Identify and obtain all information needed to complete claim review
• Manage claims with minimal supervision
• Pay all covered claims accurately and timely
• Execute on all customer performance guarantees
• Adhere to standard time frames for processing mail, tasks and outliers
• Incorporate GBS Group Operations Corporate Compliance, Policies and Procedures and best practices into daily work
• Stay abreast of ongoing trainings associated with role and business unit objectives
• Respond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely manner

• Three years minimum of professional experience strongly preferred
• HS Diploma or GED required. Bachelor’s degree strongly preferred.
• Proficiency with MS Office applications is required (Word, Outlook)
• Proven track record of successfully driving results in a complex matrix environment is a (+)
• Strong investigative skills; ability to gather relevent information, analyze facts, and draw conclusions
• Must have the ability to work with a sense of urgency and be a self-starter with a customer focus mindset
• Ability to build and maintain effective relationships
• Effective interpersonal, written and verbal communication skills
• Excellent planning, time management and organizational skills
• Ability to manage multiple and changing priorities.
• Strong negotiation skills
• Knowledge of legal liability, insurance coverage and medical terminology is a (+)
• Must be technically savvy with the ability to toggle…