[Hiring] Group Claim Associate Analyst @New York Life

Role Description

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
• 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.

Critical for success:

• Making and effectively communicating decisions within compliance guidelines
• Integrating knowledge of customer contracts, GBS Group Operations, and corporate compliance

Qualifications

• 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 plus
• Strong investigative skills; ability to gather relevant information, analyze facts, and draw conclusions
• 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 plus
• Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously

Requirements

• Conduct Waiver of Premium claim disability determinations
• Manage ongoing claims for benefits through applying appropriate contractual provisions
• Determine appropriate follow-up points for medical information following medical recommendations
• Work 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
• Respond to calls from customers and clients with minimal supervision
• 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

Benefits

• Full package of benefits for employees
• Unique offerings for a modern workforce, including leave programs, adoption assistance, and student loan repayment programs
• Annual discretionary bonus eligibility
• Participation in an incentive program