Group Claim Associate Analyst

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

Benefits offered by this job

Discretionary bonus eligible

Annual incentive program

Comprehensive benefits

Job summary

New York Life is seeking a Group Claim Associate Analyst for a fully remote role. You will develop the knowledge to complete disability investigations for Life Waiver of Premium benefits, review medical documentation, and manage ongoing claim administration.

You will work with LTD analysts, medical and vocational experts, communicate decisions to customers and employers, and ensure timely payment and compliant processing while maintaining high service standards.

Qualifications

• Minimum three years of professional experience preferred.
• HS Diploma or GED required; Bachelor’s degree preferred.
• Proficiency with MS Office (Word, Outlook) required.
• Ability to manage multiple priorities with a sense of urgency and customer focus.

Responsibilities

• Conduct Waiver of Premium claim disability determinations and manage ongoing claims.
• Collaborate with LTD analyst, Medical, and Vocational Experts for evaluation of complex medical information.
• Communicate with customers and employers to gather information on eligibility and benefits.
• Respond to calls and inquiries regarding eligibility, approvals/denials, and status of benefits.
• Identify information gaps and ensure complete claim review.

Skills

Investigative skills

Communication skills

Time management

Customer focus

Education

HS Diploma or GED

Bachelor’s degree

Tools

MS Office (Word, Outlook)

Job description

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. 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 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

What You'll Bring

• 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

Competencies

1. Decision Quality
2. Manages Complexity
3. Drives Results
4. Customer Focus
5. Communicates Effectively
6. Action Oriented

Pay Transparency

• Salary range: $51,500-$73,500
• 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 here to 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.

Recognition

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.