Senior Claim Manager (Group Insurance)

Prudential Financial; United States; Remote; USD 62,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision

PTO and leave programs

401(k) with company match

Pension plan

Wellness programs

Work/Life resources

Education benefits

Employee stock purchase plan

Job summary

Prudential Financial, a leader in financial services, seeks a Senior Claim Manager in Insurance Operations to oversee a mixed block of LTD and STD claims and deliver concierge-level service. You will guide claimants through disability processes with expert communication, handle complex cases, and document plans meticulously.

You will interact with the Leave team during quarterly reviews and coordinate with Benefits Business Partners, leveraging Expert Resources for behavioral health and

Qualifications

• 3+ years of LTD experience required.
• STD claim handling and Life Waiver of Premium preferred.
• Expert communication via multiple channels to deliver white-glove service.
• Ability to interpret complex policy and plan provisions.
• Strong documentation and organizational skills.

Responsibilities

• Oversee a block of ~75 LTD and STD claims.
• Provide excellent customer service and consultative guidance.
• Collaborate with Leave team and interface with Benefits Partners.
• Address behavioral health and vocational opportunities with Experts.
• Document conversations clearly and develop claim plans.

Skills

LTD experience

STD handling

Communication skills

Documentation skills

Policy interpretation

Team coordination

Financial math

Job description

Job Classification: Operations - Insurance Operations

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 Claim 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

Remote Work Requirements

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: Preference to be available to work Pacific Time Zone business hours; it not Pacific Time Zone, ability to work a later work shift to support customer located on the West Coast. 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.

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. 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.

• 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.

Equal Opportunity & Accommodation

Prudential Financial, Inc. 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].

If you are experiencing a technical issue with your application or an assessment, please email [e-mail] to request assistance.

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.

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. 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.