Disability Claims Specialist (remote) at Prudential Ins Co of America in Newark, New Jersey

Job Description:

Job Description:

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    Provides the highest level of technical support for a claims team, as an expert in all aspects of claim management.

    
    
  
  
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    Demonstrates an intimate understanding of all aspects of LTD, STD, and Waiver of Premium claim management/adjudication.

    
    
  
  
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    Assists in the development and coordination of training for the team (compliance, legal, medical, risk management systems, etc…).

    
    
  
  
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    Works with the team to address challenges relating to contract interpretation, procedures, complex claim assistance and or direction.

    
    
  
  
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    Acts as a liaison to the legal department, SIU, and UW department on complex issues.

    
    
  
  
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    Update and maintain SOPs and Job Aids for the team’s processes and procedures and ensuring that all key players are informed of available materials. 

    
    
  
  
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    Monitor, track, and analyze team measurements to ensure team objective and goals are met.

    
    
  
  
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    May be called upon to help with the submission of RFPs and presentations.

    
    
  
  
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    For US employees, this job is exempt and therefore not eligible for overtime.

    
    
  
  
  
  

Qualifications:

• Minimum of 3-5 years of experience in disability claim management.  Waiver experience is a plus


• Demonstrated conceptual thinking, risk management, ability to handle complex claim situations effectively.


• Demonstrated superior technical knowledge in the contract interpretation and administration.


• Superior communication, organization, risk management and time management skills required.


• Excellent customer service skills proven through internal and external customer interactions.  Coaches staff to enable excellence in customer service, claims management while demonstrating role model behaviors.  


• Ability to partner with various areas of Group Insurance.


• Goal oriented individual with an ability to identify and implement process improvements and to organize and analyze information to ensure objectives are met.