Senior LTD Appeals Analyst: Complex Cases & Impact

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

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.