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Claims Examiner (remote) at Prudential Ins Co of America

Posted in Insurance 30+ days ago.

Type: Full-Time
Location: Roseland, New Jersey





Job Description:

At Prudential, we make lives better by solving the financial challenges of our changing world. Bring your experience and unique insights to a collaborative culture focused on meeting our customer needs!  

Enabling Solutions is transforming our Enterprise-wide operating model to be a customer-obsessed organization that inspires all our employees to be bold and better in all that we do.

The U.S. Back Office Customer Service (BOCS) organization is seeking a Claims Examiner Associate to join our Group Life Claim Team of Beneficiary Fulfillment. The successful candidate will be trained to adjudicate life insurance claims for Group Insurance with a focus on accuracy, timeliness and appropriate decision making. During in-classroom and on-the-job training, the incumbent will learn how to navigate our claim system, learn about our products, policies and procedures and how to assist our customers at a time of critical need.

 

The successful candidate will be responsible for effectively adjudicating claims in order to meet production, quality and service metrics in accordance with policy/procedures and regulatory guidelines. This entails working with both internal and external partners to obtain information required for claim handling. The Claims Examiner also

 

Key Responsibilities


  • Reviews claims and extracts information for processing

  • Collects and processes death and life disability waiver claims

  • Verifies, corrects and completes claims information by telephone, letter or personal contact

  • Conducts investigations and gathers supporting documentation on claims

  • Calculates benefits payable

  • Approves (to a specified amount) or denies claims in accordance with established procedures

RSRPRUD


    • Bachelor's degree or equivalent years of industry experience preferred

    • Working knowledge of Life or Disability Claims is a plus

    • Demonstrated strong problem solving and analytical skills

    • Possesses solid customer service skills and ability to empathize with customers

    • Detail oriented

    • Ability to exercise sound judgment and risk assessment during claim adjudication

    • Exceptional verbal and written communication

    • Ability to work in a fast-paced environment and meet metrics

    • High level of flexibility to adapt to the needs of the team, division/organization

    • Available and willing to work overtime

    • Strong PC skills (Windows based environment)

    The type of individual that can be passionate about this assignment, and will be best positioned to succeed will:


    • Enjoy the challenge of working in a complicated, ever-changing and fast-moving environment.

    • Be a positive change agent, approaching each task with a ‘can do’ attitude with a goal of motivating and inspiring those around them.

    • Have proven, strong communication skills.

    • Be willing to learn new things.

    • Have strong organizational skills and be detailed oriented





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