Role Description In this role, you’ll make timely, accurate, and customer-focused claim decisions. You’ll collaborate with clinical, vocational, financial, and employer resources to gather and analyze data, compare it to policy terms, and determine claim outcomes. You may also support claim settlement efforts, ensuring optimal outcomes and compliance with regulatory standards. What you will do - Evaluate new and ongoing LTD claims promptly and accurately. - Analyze medical, vocational, and financial information against policy terms and procedural guidelines. - Apply contract language and procedural guidelines to claim decisions. - Document claim decisions thoroughly in the system. - Communicate effectively with internal and external stakeholders. - Build and maintain claim management plans for optimal outcomes. - Identify and support settlement opportunities as applicable. - Collaborate with internal resources (e.g., Actuaries, CPAs, Medical Clinicians) to support claim adjudication. - Ensure compliance with ERISA, HIPAA, Fair Claim Settlement Practices Acts, and other statutory regulations. - Deliver empathetic, customer-first service throughout all interactions. - Foster a collaborative and professional team environment. Qualifications - High School Diploma required; college degree preferred. - 3+ years of LTD claims experience required. - Experience with LTD Claim settlement efforts is a plus. - Solid understanding of disability claim processes, medical terminology, and legal/regulatory frameworks. - Proven analytical, negotiation, and conflict management skills. - Strong judgment, attention to detail, and a commitment to compassionate service. - Excellent written and verbal communication skills. - Ability to work independently and as part of a team. - Proficiency in the Microsoft Office Suite. - Experience with Fineos a plus. - Pursuing a NY Independent Adjuster license or industry designations (e.g., FLMI, CPDM) is a plus. Requirements - Employer work visa sponsorship and support are not provided for this role. - Applicants must be currently authorized to work in the United States at hire and must maintain authorization to work in the United States throughout their employment with our company. Benefits - Flexible full-time or hybrid telecommuting arrangements. - Plan for your future with our 401(k) plan and take advantage of immediate vesting and company matching up to 6%. - Paid time away including vacation and sick time, flex days and ten paid holidays. - Give back to your community and double your impact through our company matching.

• Delivering world-class support services across all Beth Israel Lahey Health, Inc. (BILH) entities • Identifying, evaluating, analyzing, and recommending changes to assigned applications • Supports the planning, design, development, and configuration of applications • Provides go-live support and serves as primary contact for maintenance and troubleshooting

• Collaborate with business partners to gather business reporting and analytics requirements to drive operational and clinical efficiency • Understand and validate the accuracy and quality of the data represented within analytics and reporting outputs • Collaborate with Data Engineering and Advanced Analytics to transform raw data into desired metrics and insights • Utilize visualization tools (e.g., PowerBI) to design and create analytics dashboards and operational reports • Train end users on newly deployed dashboards/deliverables • Support ongoing enhancements and maintenance of deployed dashboards/deliverables • Manage internal and external timelines for data reporting • Identify and track issues with reports, including defects in logic, data quality problems, and process errors • Maintain documentation of existing reports and dashboards (KPI definitions, data sources, etc.) • Other duties consistent with this role, as assigned.

• Design and evolve a structured caller intent taxonomy aligned with operational and strategic priorities • Translate unstructured conversational data into measurable signals that track resolution, escalation, repeat contacts, churn risk, and customer friction • Validate AI-generated intent classifications using structured QA frameworks, including precision and recall measurement • Identify performance drivers and friction points across the customer journey and surface actionable improvement opportunities • Build hypotheses around repeat contacts, service breakdowns, or patient confusion and test them using conversational analytics tools • Partner with operations, service delivery, and product teams to turn insights into workflow, scripting, staffing, or product improvements • Configure and refine conversational intelligence tools (such as CallMiner or similar platforms) to capture the right signals and data points • Communicate technical findings clearly to both technical and non-technical partners, translating analytics into practical decisions • Guide structured testing and validation approaches for new models, intent classifications, and operational improvements • Mentor peers and strengthen documentation and analytics practices to improve clarity, maintainability, and long-term impact