Voluntary Benefits Claims Specialist

Prudential Financial • Newark, CO

3d • $82,500 - $136,100

About The Position

The Voluntary Benefits Claims Specialist will be responsible for supporting the Voluntary Benefits Delivery Capability team for all voluntary products offered. This individual will partner closely with our vendor partner internal stakeholders to assist in the onboarding, customer administration, and claims of voluntary products. The Voluntary Benefits Claims Specialist will also work on projects, analysis, support system testing and may lead projects related to supporting the process.

Requirements

• High School Graduate/Bachelors Degree
• Familiar with Excel, Word, and Powerpoint
• Experience in Supplemental Health claims preferred
• Excels in communication and partnership

Responsibilities

• Provide support to the Delivery Capability team including but not limited to onboarding, customer administration, claims and policyholder services.
• Assist delivery partners with communication back to the customer or broker on complex claims.
• Responsible for project reporting including system testing, meeting scheduling and meeting deliverables.
• Provide coaching/mentor support to claim managers
• Identify opportunities to enhance delivery capability for product management.
• Support the documentation of standard operating procedures are and ensure they are updated and reviewed regularly with the vendor and Prudential.
• Serve as bridge between vendor and the Delivery Capability team along with other internal stakeholders (e.g., Risk, Legal, Compliance)
• Oversee the Disability and Medical claims integration processes.
• Determine actions to increase utilization and claim simplification for our customers.
• Provide support to both Product and Distribution teams, as needed.
• Monitor vendor metrics, cycle times, productivity, and quality.
• Evaluate actions and plans to improve metrics based on review of processes and system enhancements
• Provide needed data (create, run, and distribute) to key business and management.
• Gather data for the Senior Leadership Team (SLT) as required for Supplemental Health reporting.
• Support the review and response of RFP questions.
• Provide support training voluntary benefits platform and answering basic process and functionality questions.
• Manage Voluntary Benefits claims escalations through shared email inbox.
• Review 2nd appeals and provide sound decisional rationale to claims team
• NPS and Medalia survey reviews and reporting. In addition, evaluate how complaints are affecting results and recommend and deliver on actions to improve the customer experience.
• Engage in diagnosing, resolving, track and trend any issues or escalations related to the vendor, process, or customer
• Responsible for reporting emerging and escalating issues, identified through different means of communication, to ensure contractual agreements are met within the specified timeframe to meet all Prudential standards.
• Provide support for completing internal and external vendor audits and control testing.

Benefits

• Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and 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.
• Discretionary annual incentive program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level