Disability Claims Examiner – LTD
Posted 2026-05-05
Remote, USA
Full-time
Immediate Start
- Job Description:
- Provide excellent customer service while managing an assigned block of around 95 to 100 Long-Term Disability claims.
- Utilize judgment and assess risk while working with various business partners to render claim decisions.
- Partner with medical and vocational resources to evaluate disability and support return to work goals.
- Deliver an exceptional customer experience that serves to differentiate Prudential from competitors and ensures that customer commitments and deliverables are achieved.
- Communicate via telephone, email, and text with employees, employers, attorneys, and others.
- Review and interpret medical records, utilizing resources as appropriate.
- Complete financial calculations.
- Gain an understanding and working knowledge of the Prudential claim system, policies, procedures, and contracts as well as regulatory and statutory requirements for claim products administered.
- Apply contract/policy provisions to ensure accurate eligibility and liability decisions.
- Demonstrate and apply analytical and critical thinking skills.
- Verify ongoing liability and develop strategies for return-to-work opportunities as appropriate.
- Document objective, clear and technical rationale for all claim determinations and demonstrate the ability to effectively communicate claim decisions to customers via oral and written communication.
- Leverage a broad spectrum of resources, materials, and tools to render claims decisions.
- Provide timely and exceptional customer experience by paying appropriate claims accurately and timely, responding to all inquiries and maintaining expected service and quality standards.
- Work within a fast-paced environment, with tight deadlines and ability to balance multiple priorities.
- Work independently as well as within a team structure.
- Requirements:
- 2 years minimum of prior Long Term Disability Claim Management or highly relevant experience required.
- Exceptional customer service skills.
- Proven skills in positive and effective interaction with challenging customers.
- Strong written and oral communication skills demonstrated in previous work experience (preference for bilingual verbal communication in Spanish and English).
- Excellent organizational and time management skills with ability to multitask and prioritize deadlines.
- Ability to manage multiple and changing priorities.
- Detail oriented; able to analyze and research contract information.
- Demonstrated ability to operate with a sense of urgency.
- Experience in effectively meeting/exceeding individual professional expectations and team goals.
- Demonstrated analytical and math skills.
- Ability to exercise critical thinking skills, risk management skills and sound judgment.
- Ability to adapt, problem solve quickly and communicate effective solutions.
- High level of flexibility to adapt to the changing needs of the organization.
- Self-motivated, independent with proven ability to work effectively on a team and work with others in a highly collaborative team environment.
- Continuous improvement mindset.
- A commitment to support a work environment that fosters Diversity and Inclusion.
- Strong computer literacy and skills with the ability to work within multiple systems; proficiency with PC based programs such as Excel and Word.
- 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.