Senior Disability Claims Examiner – LTD

Claims SpecialistClaims SpecialistFull TimeRemoteTeam 10,001+Since 1875H1B No SponsorCompany SiteLinkedIn

Location

Arizona + 4 moreAll locations: Arizona, Maine, New Jersey, Ohio, Tennessee

Posted

58 days ago

Salary

$61.7K - $101.9K / year

Bachelor Degree4 yrs expEnglishSpanish

Job Description

• Provide excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims • Utilize judgment and assess risk as you work with various business partners to render claim decisions • Partner with medical and vocational resources to evaluate disability and support return to work goals • Deliver an exceptional customer experience that serves to differentiate Prudential from competitors • Communicate via telephone, email, and text with employees, employers, attorneys, and others • Review and interpret medical records, utilizing resources as appropriate • Complete financial calculations • Gain an understanding and working knowledge of the Prudential claim system, policies, procedures, and contracts as well as regulatory and statutory requirements for claim products administered • Apply contract/policy provisions to ensure accurate eligibility and liability decisions • Verify on-going liability and develop strategies for return-to-work opportunities as appropriate • Document objective, clear and technical rationale for all claim determinations • Leverage a broad spectrum of resources, materials, and tools to render claims decisions • Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards • Provide technical direction and/or mentorship to other claims personnel as needed

Job Requirements

  • 4+ years of experience in Long Term Disability Claim Management required
  • Exceptional customer service skills
  • Ability to solve complex claim scenarios with minimal mentorship
  • Excellent claim/risk management skills and technical knowledge in contract interpretation and administration
  • Proven skills in positive and effective interaction with challenging customers
  • Strong written and oral communication skills demonstrated in previous work experience (preference for bilingual verbal communication in Spanish and English)
  • Excellent organizational and time management skills with ability to multitask and prioritize deadlines
  • Detail oriented; able to analyze and research contract information
  • Demonstrated ability to operate with a sense of urgency
  • Experience in effectively meeting/exceeding individual professional expectations and team goals
  • Demonstrated analytical and math skills
  • Ability to exercise critical thinking skills, risk management skills and sound judgment
  • Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment
  • Continuous improvement mindset
  • A commitment to support a work environment that fosters Diversity and Inclusion
  • Strong computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word.

Benefits

  • Medical, dental, vision, life insurance, disability insurance
  • Paid Time Off (PTO)
  • Leave of absences, such as parental and military leave
  • 401(k) plan with company match (up to 4%)
  • Company-funded pension plan
  • Wellness Programs including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs
  • Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development
  • Education Benefit to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs
  • Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service
  • Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance.

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