Senior Appeals Analyst - LTD

PGIM Ireland; The Ironbound (NJ); On-site; USD 67,000 - 110,000; Full time

Benefits offered by this job

Medical, dental, vision

401(k) with company match

Pension plan

Paid Time Off

Employee Stock Purchase Plan

Job summary

Prudential is seeking a Senior Long-Term Disability Appeals Analyst to manage complex LTD appeals and coordinate with clinical, vocational, and legal experts. You will apply ERISA and state disability requirements while delivering high-level customer service.

The role emphasizes identifying trends, improving claim management, and supporting continuous process enhancements within Insurance Operations.

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.
• Working knowledge of ERISA appeal requirements, non-ERISA appeal considerations, and state-specific disability requirements.
• Demonstrated superior customer service and excellent written and verbal communication skills.

Responsibilities

• Manage a caseload of complex disability appeals.
• Utilize specialty resources (clinical, vocational, legal) as needed.
• Apply contractual provisions and administer appeals with sound judgment.
• Provide feedback on claim handling to appropriate parties and identify improvement opportunities.
• Collaborate interdepartmentally to improve claim management.

Skills

Disability appeals

Analytical thinking

Written and verbal comms

Time management

Collaboration

Education

College degree

Tools

Claim systems

Microsoft Office

Job description

Job Classification:Operations - Insurance OperationsPrudential’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 & ResponsibilitiesManage 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.Qualifications3-5 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.If you need an accommodation to complete the application process, please email [e-mail] you are experiencing a technical issue with your application or an assessment, please email [e-mail] to request assistance.