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About the Role
Group Benefit Solutions delivers comprehensive insurance and absence management solutions for mid-sized and large companies, fostering a healthier, happier, and more secure workforce. As a Group Claim Associate Analyst, you will develop the knowledge and skills needed to complete disability investigations for Life Waiver of Premium benefits, review medical documentation, administer claims, evaluate occupation eligibility, and communicate decisions. Success in this role requires managing changing volumes, paying close attention to detail, and effectively communicating decisions within compliance guidelines.
Responsibilities
- Conduct Waiver of Premium claim disability determinations and manage ongoing claims.
- Apply appropriate contractual provisions and determine follow-up points for medical information.
- Partner with LTD analysts, Medical, and Vocational Experts for complex medical information evaluation.
- Communicate with customers, business partners, and employers to gather information for eligibility assessment and ongoing benefit management.
- Respond to customer and client calls with minimal supervision.
- Respond to written and telephone inquiries regarding eligibility, approval/denial determinations, status, and benefit continuation/closure.
- Identify and obtain all necessary information for 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.
Requirements
- Three years minimum of professional experience strongly preferred.
- Proven track record of successfully driving results in a complex matrix environment is a (+).
- Strong investigative skills; ability to gather relevant 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.
- Ability to manage multiple and changing priorities.
- Must be technically savvy with the ability to toggle between multiple applications and/or computer monitors simultaneously.
Skills
- Proficiency with MS Office applications (Word, Outlook).
- Effective interpersonal, written and verbal communication skills.
- Excellent planning, time management and organizational skills.
- Strong negotiation skills.
- Knowledge of legal liability, insurance coverage and medical terminology is a (+).
Location
- Fully Remote
Work Type
- Full-time
Experience Level
- 3 years minimum professional experience preferred
Education Level
- HS Diploma or GED required.
- Bachelor’s degree strongly preferred.
Salary/Compensations
- $51,500-$73,500
Benefits
- Full package of benefits for employees.
- Leave programs.
- Adoption assistance.
- Student loan repayment programs.
About the Company
- 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.
- At our core, we provide financial security and peace of mind to people through our absence, accident, disability, voluntary benefits, and life insurance solutions.
- 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.
Equal Opportunity
- 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.