Life Waiver of Premium Claims Specialist for FPRS (Financial Protection and Retirement Solutions)

Guardian Life Insurance•Pittsfield, MA

1d•Hybrid

About The Position

As the Life Waiver of Premium Claims Specialist for FPRS (Financial Protection and Retirement Solutions), you will play a key role in delivering meaningful experiences that support growth—both for your career and for our team’s collective future. At Guardian, we live our Purpose every day. As champions of wellbeing for ourselves, our communities, and our consumers, we work together to turn what’s possible into reality. We believe in your aspirations for purpose, leadership, and achievement in both your professional and personal life, and this role provides the opportunity to bring those aspirations to life. We will help build the core competencies you will need to be a successful Life Waiver of Premium Claims Specialist. In your first year, we will provide extensive training in a highly supportive environment. If you have an internal drive to investigate using your critical thinking skills, assessing policy matters, and can manage competing priorities while meeting deadlines, this is your opportunity to make a difference, grow your career, and be a part of moving the organization into the future.

Requirements

A college or university degree or the equivalent work experience that provides knowledge and exposure to claims, service or other principles and concepts
At least two years of claim-related work experience (Individual Life Waiver of Premium or Disability Income Claims preferred)
Experience and an interest in providing quality customer service both written and telephonic
An internal drive to investigate using your critical thinking skills to assess claim and policy matters
Strong analytical skills, with attention to detail
Strong written and verbal communication skills
Demonstrated experience prioritizing competing priorities with deadlines
Working knowledge of Microsoft Office products, including Word, Excel, and Outlook
Must be legally authorized to work in the United States, without the need for employer sponsorship.

Nice To Haves

Individual Life Waiver of Premium or Disability Income Claims experience preferred

Responsibilities

Independently adjudicate Life Waiver of Premium disability claims, including initial approvals, continuations, suspensions, and terminations, in accordance with policy language and established guidelines
Evaluate medical, vocational, employer, and functional evidence (e.g., APS, medical records, functional capacity information) to determine initial and ongoing waiver eligibility
Apply Life insurance policy and rider provisions, definitions, and benefit eligibility criteria accurately and consistently to support sound claim determinations
Identify gaps, inconsistencies, or insufficiencies in evidence and take ownership to request and obtain additional information as needed
Develop clear, well‑reasoned written decision rationale that supports adjudication outcomes and withstands quality review, audit, or appeal scrutiny
Manage an active inventory of waiver claims, balancing timeliness, quality, regulatory expectations, and customer experience
Partner with internal resources (e.g., medical consultants, field investigators) to resolve adjudication issues
Communicate professionally and empathetically with policyholders, physicians, employers, representatives, and internal partners regarding claim status and decisions
Exercise sound judgment and maintain composure when making difficult or adverse disability decisions in high‑pressure situations
Collaborate within a team‑based, customer‑focused environment to meet service, quality, and performance standards