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Group Insurance Sr. Disability Claims Examiner

Role overview

Qualifications

  • 3+ years of Long-Term Disability (LTD) claim handling experience.
  • STD claim handling and Life Waiver of Premium experience and/or understanding preferred.
  • Expert-level, proactive communication skills across multiple channels (phone, email, letters, Teams) to deliver white-glove service.
  • Excellent documentation skills, strong ability to interpret complex policy provisions, and independent problem-solving in ambiguous situations.

Responsibilities

  • Manage an assigned block of approximately 75 LTD and STD disability claims, including complex cases with co-morbidities and behavioral health needs.
  • Provide concierge-level customer service and guide employees through the life cycle of a disability claim, coordinating with Expert Resources to enhance the claimant journey.
  • Interface with the client’s Leave team, Benefits Business Partners, and, when needed, attorneys and psychiatric/medical professionals; communicate via multiple channels to deliver white-glove service.
  • Identify and drive continuous process improvements within the Concierge Team and provide technical direction to other claims personnel while handling fluctuating workloads.

Other skills

  • Collaborative Communications
  • Team Effectiveness
  • Time Management
  • Organizational Skills
  • Adaptability
  • Independent Thinking
  • Customer Service

About the company

PGIM Ireland logo

PGIM Ireland

Do you imagine yourself in a career where you can balance your work life with your personal life? Are you hoping to develop your skillset and progress your career in a place where you can collaborate and consult with experts in their fields? Welcome to PGIM Ireland Work/life fit: Life in PGIM Ireland comes with many benefits that encourage a strong work/life balance for all our employees. We offer flexibility such as hybrid working, variable starting times and part time working arrangements. Career development and progression: PGIM Ireland invests heavily in Learning and Development, the philosophy being that extensive provisions are made for employees to own their careers. Each employee receives continuous training through their Individual Development Plan and, through our web-based training programme, employees are granted access to a wide range of online courses. Additionally, our educational assistance programme provides employees with an opportunity to realise their full potential and career aspirations through continuing education. As a result of these initiatives, many employees upskill and move into higher level roles within the organisation. Life in Donegal: It is no wonder Donegal was named the ‘Coolest Place on the Planet for 2017’ by National Geographic Traveller. From its blue flag beaches to its green headlands, Donegal is home to several scenic locations. Whether you’re looking for a taste of history at Glenveagh National Park or Grianán of Áileach or seeking adventure at Banba’s Crown or on the Cliff Coast, Donegal doesn’t disappoint.

Company details

Company size51 - 200

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Job description

Job Classification:

Operations - Insurance Operations

This Senior Level Claim Manager role will provide concierge-level customer service to one of Group Insurance’s largest clients. By gaining a deep understanding of the client’s culture and using expert customer service skills, the Senior Claim Manager will take a consultative approach in guiding and coaching our client’s employees through the life cycle of a disability claim. With exposure to multiple products, including Short Term Disability, Statutory Leaves, Absence, Long Term Disability, and Life Waiver of Premium, the Senior Claim Manager will deliver world-class service that ensures a more effortless experience for the employee.

As an exceptional collaborator, the Senior Claim Manager will engage Expert Resources to further enhance the claim journey, addressing Behavioral Health and Vocational opportunities within their block of claims. This Concierge Team Member will have the opportunity to interact directly with the Leave team at the client during quarterly virtual meetings and will interface daily with the client’s Benefits Business Partners.

As an innovator, the Senior Claim Manager will seek out opportunities to further enhance the claimant experience and will serve as an ambassador for continuous process improvement within the Concierge Team.

The Senior Level Claims Manager is responsible for providing excellent customer service while managing an assigned block of around 75 Long-Term Disability (LTD) and Short-Term Disability (STD) claims. The assigned claim block will fluctuate between more or fewer LTD and STD claims, depending on the team’s needs. The Senior Claims Manager will be responsible for overseeing a block of complex claims, including those with 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 a variety of pathways including telephone, email, letters, Teams messaging, group Teams calls, and one-on-one video calls to deliver exceptional, white-glove service to the customer

  • An energetic customer focus evidenced through maintaining customer relationships

  • Confidence in 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 the essence of telephone conversations and to 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 when needed

  • Advanced math skills with the ability to perform 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 & all new hires who work remotely will be held accountable to these standards:

  • Subscribe to an internet service provider plan with at least 25 Mbps download speeds. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary.

  • Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline. Your personal phone number will not be identified to customers.

  • Quiet area in your home with minimal distractions and noise-free.

  • Reliability and dependability throughout our extensive training program are required.

#LI-IN

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 $61,700.00 to $101,900.00. 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. 

  • 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. 

Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above 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, national origin, genetics, disability, 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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Marcus Rivera

Chief Revenue Officer

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