Senior Appeals Analyst - LTD

Prudential Annuities Distributors (PAD); Newark (NJ); On-site; USD 67,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, vision, life, and-dis

Disability insurance

PTO and parental/military leave

401(k) plan with company match

Company-funded pension plan

Wellness programs including $1,600/yr

Job summary

Prudential Annuities Distributors (PAD) seeks an experienced Long-Term Disability Senior Appeals Analyst to evaluate disability claim appeals and manage a caseload of complex cases within our Insurance Operations team.

In this role you will collaborate with internal/external medical, vocational, and legal experts, apply ERISA and state-specific requirements, and identify opportunities to improve claim handling and performance.

Qualifications

• 3-5 years of experience in stand-alone Long Term Disability claims.
• Disability Appeals experience highly preferred.
• Experience with Short Term Disability and Life Waiver of Premium claims preferred.
• Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific disability requirements.
• Excellent written and verbal communication skills.
• Strong analytical and critical thinking skills.
• Demonstrate collaboration skills and ability to partner interdepartmentally.

Responsibilities

• Manage and assign caseload of complex disability appeals.
• Utilize specialty resources effectively, including internal and external clinical, vocational, and legal experts.
• Demonstrate industry leading customer service internally and externally.
• Administer and expertly apply contractual provisions.
• Demonstrate excellent organizational and time management skills resulting in a well-balanced workflow.
• Exercise sound judgement in developing differentiated appeals plans that lead to optimal outcomes.
• Provide direct feedback on claim handling as required to appropriate parties.
• Identify opportunities for improved claim management across the organization.

Skills

Disability claims handling

ERISA knowledge

Analytical skills

Communication skills

Collaboration

Education

College Degree preferred

Job description

Job Classification: Operations - Insurance Operations Prudential’s Group Insurance, Disability Claim Operation is seeking an experienced and highly motivated individual to join our team as a Long-Term Disability (LTD) Sr. Appeals Analyst. This dynamic role requires the evaluation of disability claim appeals and the management of a caseload of complex appeals. The position may also provide opportunities to identify trends, optimize organizational performance, provide feedback, support continuous improvement, and identify training opportunities.

Roles & Responsibilities

• Manage and assigned caseload of complex disability appeals.
• Utilize specialty resources effectively, including internal and external clinical, vocational, and legal experts.
• Demonstrate industry leading customer service internally and externally.
• Administer and expertly apply contractual provisions.
• Demonstrate excellent organizational and time management skills resulting in a well-balanced workflow.
• Exercise sound judgement in developing differentiated appeals plans that lead to optimal outcomes.
• Provide direct feedback on claim handling as required to appropriate parties.
• Identify opportunities for improved claim management across the organization.

Qualifications

• 3-5 years of experience in stand-alone Long Term Disability claims required.
• Disability Appeals experience highly preferred.
• Experience with Short Term Disability and Life Waiver of Premium claims preferred.
• College Degree preferred.
• Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific disability requirements.
• Demonstrated superior customer service skills.
• Excellent written and verbal communication skills.
• Strong analytical and critical thinking skills required.
• Demonstrate collaboration skills and ability to partner interdepartmentally.
• Ability to work independently and manager difficult interactions to resolution.
• Proficiency with claim systems, Microsoft Office applications, and documentation tools used to research, evaluate, and record claim and appeal activity.
• Aptitude to learn and integrate new technology into workflow.

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 $66,700.00 to $110,100.00. 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).

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.

Prudential Financial, Inc. (NYSE: PRU), a global financial services leader and premier active global investment manager with approximately $1.4 trillion in assets under management as of Dec. 31, 2023, has operations in the United States, Asia, Europe, and Latin America.

Prudential’s diverse and talented employees help make lives better and create financial opportunity for more people by expanding access to investing, insurance, and retirement security. Prudential’s iconic Rock symbol has stood for strength, stability, expertise and innovation for 150 years. For more information please visit news.prudential.com.

PGIM, the global asset management business of Prudential Financial, Inc. (NYSE: PRU), is a global investment manager with US $1.3 trillion in assets under management as of Dec. 31, 2023. With offices in 18 countries, PGIM’s businesses offer a range of investment solutions for retail and institutional investors around the world across a broad range of asset classes, including public fixed income, private fixed income, fundamental equity, quantitative equity, real estate, and alternatives. For more information about PGIM, visit pgim.com.

Prudential Financial, Inc. (PFI) of the United States is not affiliated in any manner with Prudential plc, incorporated in the United Kingdom, or with Prudential Assurance Company, a subsidiary of M&G plc, incorporated in the United Kingdom. For more information please visit news.prudential.com. PGIM Inc. (PGIM) is the principal asset management business of Prudential Financial, Inc. (PFI), a company incorporated and with its principal place of business in the United States. PFI of the United States is not affiliated in any manner with Prudential plc, incorporated in the United Kingdom or with Prudential Assurance Company, a subsidiary of M&G plc, incorporated in the United Kingdom.

Our Commitment to an Inclusive Workplace

Prudential Financial, Inc. serves its customers in more than 40 countries and territories, and we seek talented, creative individuals from a variety of backgrounds, worldviews, and life circumstances to work with us. We are focused on creating a fully inclusive culture, where all employees feel comfortable bringing their authentic selves to work. We don’t just accept difference—we celebrate it, support it, and thrive on it. At Prudential, employees have a unique opportunity to build their career path by owning their development, their career, and their future. We encourage employees to hone their skills and explore continued opportunities within Prudential.

Our Commitment to an Inclusive Workplace

Prudential Financial, Inc. serves its customers in more than 40 countries and territories, and we seek talented, creative individuals from a variety of backgrounds, worldviews, and life circumstances to work with us. We are focused on creating a fully inclusive culture, where all employees feel comfortable bringing their authentic selves to work. We don’t just accept difference—we celebrate it, support it, and thrive on it. At Prudential, employees have a unique opportunity to build their career path by owning their development, their career, and their future. We encourage employees to hone their skills and explore continued opportunities within Prudential.