Group Claim Associate Analyst

New York Life Insurance Co.; New York (NY); Remote; USD 52,000 - 74,000; Full time

Job summary

New York Life Insurance Co. is seeking a Group Claim Associate Analyst to support disability investigations for Life Waiver of Premium benefits. You will review medical documentation, manage ongoing claims, and determine eligibility with a focus on accuracy and timely communications.

In this role, you’ll collaborate with specialists to assess complex medical information and ensure compliance with contractual provisions. Strong MS Office skills and a customer-first mindset are essential.

Qualifications

• Three years minimum of professional experience in disability investigations or claims processing.
• HS Diploma or GED required; Bachelor's degree strongly preferred.
• Proficiency with MS Office applications (Word, Outlook) and related tools.

Responsibilities

• Conduct Waiver of Premium claim disability determinations and manage ongoing claims.
• Collaborate with LTD analyst, Medical, and Vocational Experts for complex medical information.
• Communicate eligibility decisions and status updates with customers and clients.
• Respond to customer inquiries via phone and email within established timelines.

Skills

Decision Quality

Manages Complexity

Drives Results

Customer Focus

Communicates Effectively

Action Oriented

Education

HS Diploma or GED

Bachelor’s degree

Tools

MS Office

Job description

Job DescriptionRequisition ID94889DepartmentGroup Benefit SolutionsJob FunctionGroup Benefit SolutionsLocationRemote,New York,United StatesRole Location DesignationFully RemoteLocation Designation: Fully RemoteGroup 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. Click here to learn more about Group Benefits solutions.Role Overview: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.What You'll Do: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 informationCommunicate 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 reviewManage claims with minimal supervisionPay all covered claims accurately and timelyExecute on all customer performance guaranteesAdhere to standard timeframes for processing mail, tasks and outliersIncorporate GBS Group Operations Corporate Compliance, Policies and Procedures and best practices into daily workStay abreast of ongoing trainings associated with role and business unit objectivesRespond to all telephonic and email inquiries within customer service protocols in a clear, concise and timely mannerWhat You'll Bring:Three years minimum of professional experience strongly preferredHS 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 conclusionsMust have the ability to work with a sense of urgency and be a self-starter with a customer focus mindsetAbility to build and maintain effective relationshipsEffective interpersonal, written and verbal communication skillsExcellent planning, time management and organizational skillsAbility to manage multiple and changing priorities.Strong negotiation skillsKnowledge 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 simultaneouslyCompetencies:1. Decision Quality2. Manages Complexity3. Drives Results4. Customer Focus5. Communicates Effectively6. Action OrientedIt 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.#LI-ML1#LI-REMOTEPay TransparencySalary range: $51,500-$73,500Overtime eligible: NonexemptDiscretionary bonus eligible: YesSales bonus eligible: NoActual 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 BenefitsWe 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 here to discover more about our comprehensive benefit options or visit our NYL Benefits Site.Our Diversity PromiseWe 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: 94889#GBS