Claims Examiner (remote) at Prudential Ins Co of America in roseland, New Jersey

Job Description:

At Prudential, we make lives better by solving the financial challenges of our changing world. Bring your experience and unique insights to a collaborative culture focused on meeting our customer needs!  

Enabling Solutions is transforming our Enterprise-wide operating model to be a customer-obsessed organization that inspires all our employees to be bold and better in all that we do.

The U.S. Back Office Customer Service (BOCS) organization is seeking a Claims Examiner Associate to join our Group Life Claim Team of Beneficiary Fulfillment. The successful candidate will be trained to adjudicate life insurance claims for Group Insurance with a focus on accuracy, timeliness and appropriate decision making. During in-classroom and on-the-job training, the incumbent will learn how to navigate our claim system, learn about our products, policies and procedures and how to assist our customers at a time of critical need.

The successful candidate will be responsible for effectively adjudicating claims in order to meet production, quality and service metrics in accordance with policy/procedures and regulatory guidelines. This entails working with both internal and external partners to obtain information required for claim handling. The Claims Examiner also

Key Responsibilities

• Reviews claims and extracts information for processing


• Collects and processes death and life disability waiver claims


• Verifies, corrects and completes claims information by telephone, letter or personal contact


• Conducts investigations and gathers supporting documentation on claims


• Calculates benefits payable


• Approves (to a specified amount) or denies claims in accordance with established procedures

RSRPRUD

• Bachelor's degree or equivalent years of industry experience preferred


• Working knowledge of Life or Disability Claims is a plus


• Demonstrated strong problem solving and analytical skills


• Possesses solid customer service skills and ability to empathize with customers


• Detail oriented


• Ability to exercise sound judgment and risk assessment during claim adjudication


• Exceptional verbal and written communication


• Ability to work in a fast-paced environment and meet metrics


• High level of flexibility to adapt to the needs of the team, division/organization


• Available and willing to work overtime


• Strong PC skills (Windows based environment)

The type of individual that can be passionate about this assignment, and will be best positioned to succeed will:

• Enjoy the challenge of working in a complicated, ever-changing and fast-moving environment.


• Be a positive change agent, approaching each task with a ‘can do’ attitude with a goal of motivating and inspiring those around them.


• Have proven, strong communication skills.


• Be willing to learn new things.


• Have strong organizational skills and be detailed oriented