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Senior Claims Examiner

Prudential


Location:
Roseland, NJ
Date:
04/28/2017
Job Code:
399519
Prudential
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Job Details

Position Title: Senior Claims Examiner
Job Code: 399519
Job Location: New Jersey-Roseland
Description:

Prudential’s Office of Servicemembers' Group Life Insurance (OSGLI) is interviewing for a Sr. Claim Examiner position on the OSGLI Claim’s team.  The Office of Servicemembers' Group Life Insurance (OSGLI) administers the Servicemembers' Group Life Insurance program (SGLI). SGLI offers life insurance products to active duty service members, veterans, and their families. Prudential has been servicing our service members since 1965.

 

The OSGLI organization is focused on building the Ultimate Customer Experience.  The Senior Claim Examiner is responsible to assist the team in management of daily activities over a group of claims examiners.  The Senior Claim Examiner will provide decisions, guidance and direction to the claims staff on all death and traumatic injury claim handling, including complex claims.  The role has a higher authority limit than Advanced Examiners and provides on-going claims support through outbound calls, appropriate follow up, letter and personal contact, dealing directly with both internal and external customers (Veterans’ Administration, Special Investigations Unit, Enterprise Legal Processing Unit and the Law department).  The role is held to high standards of customer service and support.  The successful candidate will be a customer focused individual who pays close attention to details, is responsible for analyzing and making decisions on claims, calculating benefits payable, and approving or denying claims in accordance with established procedures.  The position offers the potential to move within both the OSGLI and Prudential organizations.

 

Essential Job Functions:

 

The Senior Claim Examiner responsibilities may now or in the future include direct reports.  The individual selected for this opening will:

 

 

  • Serve as a liaison between the OSGLI and the Group Insurance Law Department and Special Investigations Unit (SIU).
  • Serve as Complaint/Congressional Inquiry coordinator.
  • Serve as technical advisor to all OSGLI staff.
  • Serve as back up to team leadership.
  • Handle complex claims (i.e. competing claims, beneficiary involvement, Law referrals)
  • Manage aged claims for efficient resolution.
  • Prepare answers to interrogatories, responses to subpoena and document requests, and affidavits on claims and on active policies.
  • Assist with preparation of training material and conduct training for new claim employees.
  • Review/approval of claim payments above the Claim Examiners authority limit.
  • Conducts claim management reviews of claim cases.
  • Handling escalated customer/claim calls
  • Assist in monitoring the section’s workflow.
  • Process claim payments when necessary.
  • Possess the flexibility to perform other duties as assigned.

     

 


  • Bachelor's degree, or equivalent military experience, preferred    
  • Prior claims handling experience desired
  • Prior group life claims experience preferred (3-5 years)
  • Strong customer focus skills with high ability to empathize with customers
  • Ability to learn and retain a large amount of technical information
  • Ability to analyze data on claims and make appropriate claim decisions
  • Strong issue identification and problem solving skills
  • Ability to prepare replies to complex/congressional claim inquiries
  • Excellent PC skills and strong working knowledge of windows-based applications
  • Proven self-motivation skills
  • Excellent verbal and written communications skills
  • Partnership skills with an ability to excel in a team environment and be a team player, as well as work well independently
  • Ability to prioritize work and excel in a fast-paced, metric driven environment
  • Excellent time management and organizational skills
  • Close attention to detail a must
  • Ability to work from home when needed. Upon the successful completion of training and a period of time of meeting all operational metrics, an alternate work schedule is possible. 

     

 

Additional information:

Any applicant selected for this position will be required to submit to a background screening, including a criminal and credit check conducted by the Department of Veterans Affairs as a condition of employment in the Office of Servicemembers' Group Life Insurance.  An applicant's refusal or failure to comply with this requirement will cause the applicant to become ineligible for this position.  In addition, an applicant's failure to pass the Department of Veterans Affairs background screen may result in disciplinary action up to and including the termination of employment.

 

OSGLI is located at Prudential's office in Roseland, NJ. This is not a virtual position, although an alternate work arrangement is possible for successful associates.

 

Prudential is a multinational financial services leader with operations in the United States, Asia, Europe, and Latin America. Leveraging its heritage of life insurance and asset management expertise, Prudential is focused on helping individual and institutional customers grow and protect their wealth. The company's well-known Rock symbol is an icon of strength, stability, expertise and innovation that has stood the test of time. Prudential's businesses offer a

variety of products and services, including life insurance, annuities, retirement-related services, mutual funds, asset management, and real estate services.  We recognize that our strength and success are directly linked to the quality and skills of our diverse associates. We are proud to be a place where talented people who want to make a difference can grow as professionals, leaders, and as individuals. Visit www.prudential.com to learn more about our values, our history and our brand.  Prudential is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, disability status, protected veteran status, or any other characteristic protected by law.  Note that this posting is intended for individual applicants.  Search firms or agencies should email Staffing at

staffingagencies@prudential.com for more information about doing business with Prudential.


Prudential is a multinational financial services leader with operations in the United States, Asia, Europe, and Latin America. Leveraging its heritage of life insurance and asset management expertise, Prudential is focused on helping individual and institutional customers grow and protect their wealth. The company's well-known Rock symbol is an icon of strength, stability, expertise and innovation that has stood the test of time. Prudential's businesses offer a variety of products and services, including life insurance, annuities, retirement-related services, mutual funds, asset management, and real estate services.

We recognize that our strength and success are directly linked to the quality and skills of our diverse associates. We are proud to be a place where talented people who want to make a difference can grow as professionals, leaders, and as individuals. Visit www.prudential.com to learn more about our values, our history and our brand.

Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, genetics, disability, age, veteran status, or any other characteristic protected by law.

Note that this posting is intended for individual applicants. Search firms or agencies should email Staffing at staffingagencies@prudential.com for more information about doing business with Prudential.
Job Function: Claims
Schedule: Full-time
Apply on the Company Site

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