Disability Claims Examiner (Remote) (Finance)

Job Classification:

Operations - Insurance Operations

We are excited to announce a career opportunity within the Standalone, Concierge, and Association Teams Organization. We are currently seeking a Short-Term Disability (STD) Claim Examiner to join the International Brotherhood of Teamsters (IBT) STD & LTD Claim Team.

The Short-Term Disability (STD) Claim Examiner will be responsible for handling a complex claim block of STD claims for a dedicated account. The STD Claim Examiner is accountable for ensuring exceptional customer service, optimal claims handling, and timely, accurate decisions. This role demands a diverse skill set, including but not limited to:

• Expertly evaluating and managing an assigned block of Complex claims.
• Focusing on the customer experience to deliver exemplary service.
• Utilize all available resources to determine initial and ongoing STD eligibility.
• Demonstrating the ability to provide accurate, dependable, and trustworthy service to our valued customers.
• Maintaining strong customer relationships through exceptional service.
• Communicate effectively, both written and verbal, with strong negotiating and influencing skills.
• Interacting with internal and external stakeholders, including claimants, employers, physicians, attorneys, and others, to gather necessary information for claim decisions.
• Providing technical direction to other claims personnel as needed.
• Ensuring payment period validation, monitoring payment accuracy and timeliness, and overseeing closure plans for other claims personnel as required.
• Apply strong medical terminology knowledge

JOB REQUIREMENTS:
• A minimum of 2-3 years' experience of Short-Term Disability claim experience required. 　
• Ability to solve complex claim scenarios with minimal guidance.　
• Ability to manage multiple and changing priorities.　
• Claim/risk management skills and technical knowledge in contract interpretation and administration.
• Excellent organizational and time management skills.　
• Strong written and communication skills demonstrated in previous work experience.　
• Specific experience with collaborative negotiations.　
• Proven skills in positive and effective interaction with challenging customers.　
• Experience in effectively meeting/exceeding individual professional expectations and team goals.　
• Demonstrated analytical and math skills.　
• Ability to exercise sound judgment.　
• Goal oriented with an ability to organize and analyze information.
• Strong critical thinking skills, communication, organization, and time management skills.
• Proven customer service skills.
• Demonstrated ability to adapt to the changing needs of an organization.
• PC skills required (i.e., Windows based environment; Word; Excel; PowerPoint)

This position will work virtually, therefore new hires must be able to provide the following:
• High speed internet service must be available in your area. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary. The internet service cannot be wireless, and the internet speed requirement is: 3.0 mg downstream and 768k upstream.
• Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline. You will be logging into Avaya therefore your personal phone number will not be identified to customers.
• Quiet area in your home with minimal distractions and noise free.

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. The salary range for this role is from $55,300.00 to $82,300.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.

• Market competitive base salaries, with a yearly bonus potential at every level.