Group Claim Associate Analyst

New York Life•New York, NY

15h•$51,500 - $73,500•Remote

About The Position

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.

Requirements

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 between multiple applications and/ or computer monitors simultaneously

Responsibilities

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 timeframes 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