Senior Appeals Analyst (Remote)

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 Sr.

Appeals Analyst. This position is a dynamic role requiring the evaluation of disability claim appeals. In addition to managing a caseload of complex appeals, this position may offer the opportunity to identify trends to optimize the performance of the organization including providing feedback, initiating continuous improvement, and identifying training opportunities.

Roles & Responsibilities

• Manage assigned caseload of complex disability appeals.
• Utilize specialty resources effectively to include 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.
• Demonstrate sound judgment in the development of differentiated appeals plans leading to optimal outcomes.
• Provides direct feedback to appropriate parties as required on claim handling.
• Identify opportunities for improved claim management across the organization.

Qualifications

• 2-5 years experience in Long Term Disability claims required
• Experience with Short Term Disability and Life WOP claims is preferred
• Prior appeals experience preferred
• College degree preferred
• Demonstrated superior customer service skills
• Excellent verbal and written correspondence skills
• Successful analytical and critical thinking skills required
• Demonstrated collaboration and ability to partner inter-departmentally
• Ability to work independently to manage difficult interactions
• Proficiency in Microsoft Office
• Aptitude to learn and integrate new technology into work flow

At Prudential, you can :

Take charge of your career. We equip and empower our employees to expand their skills and experience by using powerful learning, gigs, and job opportunities.

We offer a suite of services including 1 : 1 Career advice, on demand resources and networking to propel your career forward.

We’re a global organization, full of outstandingly dedicated people who aren’t afraid to think differently, challenge the status quo and take sensible risks along the way.

You will enjoy pushing boundaries as we build innovative technology that helps clients, customers and employees live their best lives.

You will have access to leadership and learning opportunities and the resources needed to take your career in any direction.

We will help you do your best work, offering flexibility, while delivering on our Purpose.

What we offer you :

• Market driven 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.
• Retirement plans : 401(k) plan with company match (up to 4%)
• 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.
• Tuition Assistance to help finance traditional college enrollment toward obtaining an approved degree, many accredited certificate programs, and industry designations.
2 days ago