Senior Disability Claims Examiner (Virtual)

Prudential Financial; Portland (ME); On-site; USD 62,000 - 102,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

401(k) plan with company match

Pension plan

Wellness programs

Education benefits

Employee Stock Purchase Plan

Job summary

Prudential Financial, Inc. seeks a Senior Level Claim Manager to provide top-tier customer service to a major Group Insurance client, guiding employees through STD and leave processes. You will handle calls, analyze complex claims, and drive improvements while collaborating with the client’s Leave and Benefits teams.

The role is virtual, with requirements for reliable home setup and strong multitasking. A focus on quality service and precise documentation supports ongoing client relationships

Qualifications

• 2-3 years of STD experience; FMLA/State Leave preferred.
• Proactive multi-channel communication (phone, email, letters, Teams) to deliver exceptional service.
• Energetic, customer-focused with strong relationships.
• Ability to communicate with highly skilled claimants in a software industry context.
• Excellent documentation to capture conversations and craft clear claim plans.
• Ability to interpret complex policy and plan provisions.
• Navigate ambiguous situations independently and adapt quickly.
• Strong organizational and time management skills.
• Demonstrated analytical and math skills.
• Provide technical direction to other claims personnel as needed.
• Strong teamwork to leverage resources.

Responsibilities

• Provide excellent customer service while managing approximately 95 Short-Term Disability (STD) claims.
• Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health issues, and self-reported symptoms.

Skills

STD experience

Proactive communication

Customer-focused

Communicating with claimants

Documentation skills

Policy interpretation

Ambiguity navigation

Organization & time management

Analytical skills

Technical direction to others

Teamwork

Job description

Job Classification

Operations - Insurance Operations

We are seeking a Senior Level Claim Manager to provide top-tier customer service to one of our largest Group Insurance clients. In this role, you will gain a deep understanding of the client's culture and apply your expert customer service skills to guide and support their employees at the start of their leave. You will work with various products, including Short Term Disability, Statutory Leaves, and Absence, to ensure a seamless experience for employees.

As a member of this team, you will go beyond traditional claim management duties. This includes handling customer service calls specifically for your assigned client. You are expected to become thoroughly familiar with the client's culture and product offerings to deliver exceptional service to both the client and their employees. You will look for opportunities to enhance the claimant experience and act as a champion for continuous process improvement within the Concierge Team. You will have the chance to interact with the client's Leave team during quarterly virtual meetings and will engage daily with the client's Benefits Business Partners.

Responsibilities

• Provide excellent customer service while managing approximately 95 Short-Term Disability (STD) claims.
• Oversee a portfolio of complex claims, including those involving co-morbidities, behavioral health issues, and self-reported symptoms.

Qualifications

• 2-3 years of experience in STD is required (FMLA/State Leave experience is preferred).
• Proficient in proactive communication through various channels, such as phone, email, letters, Teams messaging, group Teams calls, and one-on-one video calls, to deliver exceptional service.
• Energetic and customer-focused, with a proven ability to maintain strong customer relationships.
• Confident in communicating with highly skilled and educated claimants in the software industry, especially in challenging situations.
• Excellent documentation skills to accurately capture telephone conversations and create clear, concise claim plans.
• Ability to understand and interpret complex and non-standard policy and plan provisions.
• Strong ability to independently navigate ambiguous situations and adapt quickly when needed.
• Excellent organizational and time management skills.
• Demonstrated analytical and math skills.
• Provide technical direction to other claims personnel as needed.
• Strong teamwork skills and the ability to leverage resources to achieve goals.

Work Environment

This role is virtual, so candidates must meet the following requirements:

• Subscribe to an internet service provider plan with at least 25 Mbps download speeds and be willing to troubleshoot any connectivity issues.
• Capable of handling calls with a cell phone (with unlimited data and minutes) or a landline. Your personal phone number will not be disclosed to customers.
• Have a quiet, distraction-free work area at home.
• Preference to be available to work Pacific Time Zone business hours; if not Pacific Time Zone, ability to work a later work shift to support customer located on the West Coast.
• Demonstrate reliability and dependability throughout the extensive training program.

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).

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].

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