Group Insurance Sr. Disability Claims Examiner
Prudential Ins Co of America, Portland, OR, United States
Job Classification: Operations - Insurance Operations
Senior Level Claim Manager role will provide concierge-level customer service to one of Group Insurance's largest clients. Gain deep understanding of the client's culture and use expert customer service skills to guide and coach employees through the life cycle of a disability claim. Exposure to multiple products: Short Term Disability, Statutory Leaves, Absence, Long Term Disability, Life Waiver of Premium. Deliver world‑class service for an effortless employee experience.
As an exceptional collaborator, engage Expert Resources to enhance the claim journey, addressing Behavioral Health and Vocational opportunities within the block of claims. Interact directly with the Leave team at the client during quarterly virtual meetings and interface daily with the client's Benefits Business Partners.
As an innovator, seek opportunities to enhance claimant experience and serve as ambassador for continuous process improvement within the Concierge Team.
Responsible for providing excellent customer service while managing an assigned block of around 75 Long‑Term Disability (LTD) and Short‑Term Disability (STD) claims. Block fluctuates; responsible for complex claims including co‑morbidities, behavioral health issues, and self‑reported symptoms.
Qualifications:
3+ years of LTD experience is required
STD claim handling and Life Waiver of Premium experience and/or understanding is preferred
Expert‑level, proactive communication skills using telephone, email, letters, Teams messaging, group Teams calls, and one‑on‑one video calls to deliver exceptional, white‑glove service
Energetic customer focus evidenced through maintaining customer relationships
Confidence communicating with highly skilled and highly educated claimants in the software industry
Ability to interact confidently with attorneys and specialty medical professionals such as psychiatric providers
Excellent documentation skills to capture telephone conversations and establish clear, concise claim plans
Ability to comprehend and interpret complex and non‑standard policy and plan provisions
Strong ability to independently work through ambiguous situations and adjust course quickly
Advanced math skills for financial calculations related to salary and incentives, partial disability calculations, RTW incentives, and offsets
Provides technical direction to other claims personnel as needed
Excellent organizational and time management skills
Demonstrated teamwork skills and ability to leverage resources to attain goals
This position will work virtually; therefore, new hires must be able to provide the following and all new hires who work remotely will be held accountable to these standards:
Subscribe to internet service provider plan with at least 25 Mbps download speeds and troubleshoot any issues or outages
Must have capability to handle calls with a cell phone (unlimited data and minutes) or a landline. Personal phone number not identified to customers.
Quiet area in home with minimal distractions and noise‑free
Reliability and dependability throughout extensive training program required
What we offer you:
Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. Salary range $61,700.00 to $101,900.00 varies within the range based on location, experience, and skills.
Market competitive base salaries, with yearly bonus potential at every level
Medical, dental, vision, life insurance, disability insurance, PTO, and leave of absences (parental, military)
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 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 college enrollment toward approved degree and certificate programs
Employee Stock Purchase Plan: shares can be purchased at 85% of the lower of two prices (Beginning or End of purchase period) after one year of service
Eligibility to participate in a discretionary annual incentive program is subject to rules governing the program. Some benefits may not apply to part‑time employees scheduled to work less than 20 hours per week.
Prudential Financial, Inc. of the United States is not affiliated with Prudential plc., which is headquartered in the United Kingdom.
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, genetic, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.
If you need an accommodation to complete the application process, please email accommodations.hw@prudential.com .
If you are experiencing a technical issue with your application or an assessment, please email careers.technicalsupport@prudential.com to request assistance.
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Senior Level Claim Manager role will provide concierge-level customer service to one of Group Insurance's largest clients. Gain deep understanding of the client's culture and use expert customer service skills to guide and coach employees through the life cycle of a disability claim. Exposure to multiple products: Short Term Disability, Statutory Leaves, Absence, Long Term Disability, Life Waiver of Premium. Deliver world‑class service for an effortless employee experience.
As an exceptional collaborator, engage Expert Resources to enhance the claim journey, addressing Behavioral Health and Vocational opportunities within the block of claims. Interact directly with the Leave team at the client during quarterly virtual meetings and interface daily with the client's Benefits Business Partners.
As an innovator, seek opportunities to enhance claimant experience and serve as ambassador for continuous process improvement within the Concierge Team.
Responsible for providing excellent customer service while managing an assigned block of around 75 Long‑Term Disability (LTD) and Short‑Term Disability (STD) claims. Block fluctuates; responsible for complex claims including co‑morbidities, behavioral health issues, and self‑reported symptoms.
Qualifications:
3+ years of LTD experience is required
STD claim handling and Life Waiver of Premium experience and/or understanding is preferred
Expert‑level, proactive communication skills using telephone, email, letters, Teams messaging, group Teams calls, and one‑on‑one video calls to deliver exceptional, white‑glove service
Energetic customer focus evidenced through maintaining customer relationships
Confidence communicating with highly skilled and highly educated claimants in the software industry
Ability to interact confidently with attorneys and specialty medical professionals such as psychiatric providers
Excellent documentation skills to capture telephone conversations and establish clear, concise claim plans
Ability to comprehend and interpret complex and non‑standard policy and plan provisions
Strong ability to independently work through ambiguous situations and adjust course quickly
Advanced math skills for financial calculations related to salary and incentives, partial disability calculations, RTW incentives, and offsets
Provides technical direction to other claims personnel as needed
Excellent organizational and time management skills
Demonstrated teamwork skills and ability to leverage resources to attain goals
This position will work virtually; therefore, new hires must be able to provide the following and all new hires who work remotely will be held accountable to these standards:
Subscribe to internet service provider plan with at least 25 Mbps download speeds and troubleshoot any issues or outages
Must have capability to handle calls with a cell phone (unlimited data and minutes) or a landline. Personal phone number not identified to customers.
Quiet area in home with minimal distractions and noise‑free
Reliability and dependability throughout extensive training program required
What we offer you:
Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. Salary range $61,700.00 to $101,900.00 varies within the range based on location, experience, and skills.
Market competitive base salaries, with yearly bonus potential at every level
Medical, dental, vision, life insurance, disability insurance, PTO, and leave of absences (parental, military)
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 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 college enrollment toward approved degree and certificate programs
Employee Stock Purchase Plan: shares can be purchased at 85% of the lower of two prices (Beginning or End of purchase period) after one year of service
Eligibility to participate in a discretionary annual incentive program is subject to rules governing the program. Some benefits may not apply to part‑time employees scheduled to work less than 20 hours per week.
Prudential Financial, Inc. of the United States is not affiliated with Prudential plc., which is headquartered in the United Kingdom.
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, genetic, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.
If you need an accommodation to complete the application process, please email accommodations.hw@prudential.com .
If you are experiencing a technical issue with your application or an assessment, please email careers.technicalsupport@prudential.com to request assistance.
#J-18808-Ljbffr