About the position
The Long-Term Disability (LTD) Disability Claims Examiner is a vital role within Prudential's Group Insurance Business, specifically focusing on managing Long-Term Disability claims. This position is designed for individuals who are committed to providing exceptional customer service while handling an assigned block of approximately 95 to 100 claims. As a Disability Claims Examiner, you will be responsible for utilizing your judgment and assessing risk in collaboration with various business partners to make informed claim decisions. This role requires a strong partnership with medical and vocational resources to evaluate disability claims and support return-to-work goals. In this position, you will be expected to deliver an exceptional customer experience that sets Prudential apart from its competitors. This includes effective communication through various channels such as telephone, email, and text with employees, employers, attorneys, and other stakeholders. You will review and interpret medical records, perform financial calculations, and gain a comprehensive understanding of Prudential's claim system, policies, procedures, and regulatory requirements. Your analytical and critical thinking skills will be essential as you document clear and objective rationales for all claim determinations and communicate these decisions effectively to customers. The role also demands the ability to work within a fast-paced environment, balancing multiple priorities while maintaining high service and quality standards. You will work independently and as part of a team, demonstrating flexibility and a commitment to continuous improvement. The position is fully remote, requiring a reliable internet connection and a quiet workspace to ensure productivity and focus during work hours.
Responsibilities
- Manage an assigned block of approximately 95 to 100 Long-Term Disability claims.
- Provide excellent customer service and deliver an exceptional customer experience.
- Communicate effectively via telephone, email, and text with various stakeholders.
- Review and interpret medical records and perform financial calculations.
- Understand and apply Prudential's claim system, policies, procedures, and regulatory requirements.
- Document clear and objective rationales for claim determinations.
- Work with medical and vocational resources to evaluate disability and support return-to-work goals.
- Verify ongoing liability and develop strategies for return-to-work opportunities.
- Maintain expected service and quality standards while responding to inquiries.
Requirements
- Minimum of 1 year of prior Disability Claims experience.
- Exceptional customer service skills.
- Proven ability to interact positively with challenging customers.
- Strong written and oral communication skills, with a preference for bilingual communication in Spanish and English.
- Excellent organizational and time management skills with the ability to multitask and prioritize deadlines.
- Detail-oriented with the ability to analyze and research contract information.
- Demonstrated analytical and math skills.
- Ability to exercise critical thinking skills and sound judgment.
- Self-motivated and able to work effectively in a team environment.
Nice-to-haves
- Experience in a fast-paced environment with tight deadlines.
- Ability to adapt and problem-solve quickly.
- Continuous improvement mindset.
- Strong computer literacy, particularly with Excel and Word.
Benefits
- Market-driven base salaries with yearly bonus potential.
- Medical, dental, vision, life insurance, and disability insurance.
- Paid Time Off (PTO) and leave of absences, including parental and military leave.
- 401(k) plan with company match (up to 4%).
- Work/Life Resources for various personal support topics.
- Tuition Assistance for traditional college enrollment and accredited certificate programs.
