Disability Claims Examiner (Remote)

Posted:
8/15/2024, 5:00:00 PM

Location(s):
Portland, Maine, United States ⋅ Maine, United States

Experience Level(s):
Junior

Field(s):
Customer Success & Support ⋅ Operations & Logistics

Workplace Type:
Remote

Job Classification:

Operations - Insurance Operations

Prudential is a company of smart, ambitious professionals working together across a multitude of disciplines. Together, we are building a better financial future for our customers and our communities around the globe. At Prudential, we understand that a company is only as good as its people. This simple fact is central to all that we do.

The Team

You will be part of the Long-Term Disability (LTD) Claims team which is part of our Group Insurance Business.  We have Long-Term Disability teams based out of New Jersey, Maine, and Arizona as well as fully remote teams.

The Role

The Long-Term Disability (LTD) Disability Claims Examiner is responsible for providing excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions. As a claim manager you will partner with medical and vocational resources to evaluate disability and support return to work goals. Additional responsibilities include:

  • Deliver an exceptional customer experience that serves to differentiate Prudential from our competitors and ensures that customer commitments and deliverables are achieved.                                                                
  • Communication 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.
  • Demonstrate and apply analytical and critical thinking skills.
  • Verify on-going liability and develop strategies for return-to-work opportunities as appropriate.
  • Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication.
  • 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.
  • Work within a fast-paced environment, with tight deadlines and the ability to balance multiple priorities.
  • Work independently as well as within a team structure.

What You’ll Need to Succeed:

  • 1 year minimum of prior Disability Claims experience
  • Exceptional customer service skills
  • 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.            
  • Ability to manage multiple and changing priorities.
  • 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.        
  • Ability to adapt, problem solve quickly and communicate effective solutions.                                   
  • High level of flexibility to adapt to the changing needs of the organization. 
  • 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.

Additional Information:

This position will work virtually, therefore new hires must be able to provide the following:

  • Subscribe to internet service provider plan with at least 25 Mbps download speeds. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary. Wired Ethernet (connected into router or Wi-Fi extender or MESH), NOT connecting computer over Wi-Fi.
  • Use of USB wired headset with a noise cancellation feature (required for all CSP’s, optimal for all other roles)
  • Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline.  Your personal phone number will not be identified to customers.
  • Quiet area in your home with minimal distractions and noise free.
  • Reliability and Dependability throughout our extensive training program is required

At Prudential, you can:

Take charge of your career. We equip and empower our employees to expand their skills and experience by using powerful learning, gigs, and job opportunities. We offer a suite of services including 1:1 Career advice, on demand resources and networking to propel your career forward.

We’re a global organization, full of outstandingly dedicated people who aren’t afraid to think differently, challenge the status quo and take sensible risks along the way. You will enjoy pushing boundaries as we build innovative technology that helps clients, customers and employees live their best lives. You will have access to leadership and learning opportunities and the resources needed to take your career in any direction. We will help you do your best work, offering flexibility, while delivering on our Purpose.

What we offer you:

  • Market driven base salaries, with a yearly bonus potential at every level
  • Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave.
  • Retirement plans: 401(k) plan with company match (up to 4%)
  • 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.
  • Tuition Assistance to help finance traditional college enrollment toward obtaining an approved degree, many accredited certificate programs, and industry designations.

To find out more about our Total Reward package, visit Work Life Balance | Prudential Careers . Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.

RSRPRUD

Note: Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $54,000.00 to $80,300.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills. Roles may also be eligible for additional compensation and/or benefits. 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. In addition, employees are eligible for standard benefits package including paid time off, medical, dental and retirement.

Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.

Prudential is a multinational financial services leader with operations in the United States, Asia, Europe, and Latin America. Leveraging its heritage of life insurance and asset management expertise, Prudential is focused on helping individual and institutional customers grow and protect their wealth. The company's well-known Rock symbol is an icon of strength, stability, expertise and innovation that has stood the test of time. Prudential's businesses offer a variety of products and services, including life insurance, annuities, retirement-related services, mutual funds, asset management, and real estate services.

We recognize that our strength and success are directly linked to the quality and skills of our diverse associates. We are proud to be a place where talented people who want to make a difference can grow as professionals, leaders, and as individuals. Visit www.prudential.com to learn more about our values, our history and our brand.

Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status , medical condition or any other characteristic protected by law. 

The Prudential Insurance Company of America, Newark, NJ and its affiliates.

Note that this posting is intended for individual applicants. Search firms or agencies should email Staffing at [email protected] for more information about doing business with Prudential.

PEOPLE WITH DISABILITIES:
If you need an accommodation to complete the application process, which may include an assessment, please email
[email protected].

Please note that the above email is solely for individuals with disabilities requesting an accommodation.  If you are experiencing a technical issue with your application or an assessment, please email [email protected] to request assistance.

Prudential Financial

Website: http://www.prudential.com/

Headquarter Location: Newark, New Jersey, United States

Employee Count: 10001+

Year Founded: 1875

IPO Status: Public

Last Funding Type: Post-IPO Debt

Industries: Asset Management ⋅ Finance ⋅ Financial Exchanges ⋅ Financial Services ⋅ Insurance ⋅ Health Care ⋅ Retirement