Disability Claims Examiner II (Bilingual Preferred, Remote) – R-121009 Position Available In Cumberland, Maine

Disability Claims Examiner II (Bilingual Preferred, Remote) – R-121009 at Prudential Ins Co of America in

Portland, Maine, United States Job Description Job Classification:

Operations – Insurance Operations Prudential is a company of smart, ambitious professionals working together across a multitude of disciplines. Together, we are building a better financial future for our customers and our communities around the globe. At Prudential, we understand that a company is only as good as its people. This simple fact is central to all that we do. The Team You will be part of the Long-Term Disability (LTD) Claims team which is part of our Group Insurance Business. We have Long-Term Disability teams based out of New Jersey, Maine, and Arizona as well as fully remote teams. The Role The Long-Term Disability (LTD) Disability Claims Examiner is responsible for providing excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims. You will be expected to utilize judgment and assess risk as you work with various business partners to render claim decisions. As a claim manager you will partner with medical and vocational resources to evaluate disability and support return to work goals.

Additional responsibilities include:

Deliver an exceptional customer experience that serves to differentiate Prudential from our competitors and ensures that customer commitments and deliverables are achieved.
Communication via telephone, email, and text with employees, employers, attorneys, and others.
Review and interpret medical records, utilizing resources as appropriate.
Complete financial calculations
Gain an understanding and working knowledge of the Prudential claim system, policies, procedures, and contracts as well as regulatory and statutory requirements for claim products administered.
Apply contract/policy provisions to ensure accurate eligibility and liability decisions.
Demonstrate and apply analytical and critical thinking skills.
Verify on-going liability and develop strategies for return-to-work opportunities as appropriate.
Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to our customers via oral and written communication.
Leverage a broad spectrum of resources, materials, and tools to render claims decisions.
Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards.
Work within a fast-paced environment, with tight deadlines and the ability to balance multiple priorities.
Work independently as well as within a team structure. What Youll Need to

Succeed:

o 2-3 year minimum of prior Long Term Disability Claim Management or highly relevant experience required
o Exceptional customer service skills
o Proven skills in positive and effective interaction with challenging customers
o Strong written and oral communication skills demonstrated in previous work experience (preference for bilingual verbal communication in Spanish and English)
o Excellent organizational and time management skills with ability to multitask and prioritize deadlines.
o Ability to manage multiple and changing priorities.
o… Equal Opportunity Employer