As Senior Appeals Analyst, evaluate disability claims appeals and manage complex caseload. Engage with internal and external experts to enhance performance at Prudential.
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.
Requirements
3-5 years' experience in Long Term Disability claims required.
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 workflow.
Experience with Short Term Disability and Life WOP claims is preferred.
Prior appeals experience preferred.
College degree preferred.
Benefits
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), after one year of service.
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.
Senior Due Diligence Analyst responsible for KYC onboarding and compliance processes in a hybrid working environment. Supporting the French business with expertise in AML policy requirements and relationship management.
Senior IT Analyst managing IT vendor governance and contract lifecycle at iA Financial Group. Focused on performance optimization, compliance, and maximizing non - financial benefits.
Sr. Benefits Analyst managing AV’s benefits administration and compliance while supporting employee experience. Collaborating with Payroll, Finance, Legal, HR Business Partners, and vendors for accurate plan operations.
Background Check Analyst conducting vetting and background reviews for safety and wellness checks. Collaborating with multidisciplinary teams to analyze sensitive information and make sound decisions.
Investigative Analyst conducting detailed research, analysis to identify fraud and assess risk. Supporting investigative decision - making for the Providencia Group in El Paso or Weslaco, TX.
Analyst role in strategy consulting team providing insights through qualitative and quantitative data analysis for diverse client projects at Brave Bison.
Contract & Onboarding Operations Lead managing MPS and MDS onboarding for NA AMS region. Serving as a key Subject Matter Expert ensuring operational excellence and compliance.
Reconciliation Analyst assisting with account reconciliation and analysis at Fiserv. Collaborating with cross - functional teams to implement solutions and drive positive change.
Senior Quality Assurance Analyst ensuring high quality standards while supporting multidisciplinary game development teams. Proactively identifying and implementing testing supports for quality improvements in new games.
Senior Data Visualization Analyst enhancing healthcare datasets and visualization strategies. Collaborating across teams to drive analytics standards and provide data - driven solutions.