Senior Claims Examiner (Virtual)

About the Role

As a Senior Claims Examiner, you will be responsible for adjudicating life insurance claims with a focus on accuracy, timeliness, and appropriate decision-making. This involves not only processing claims but also interacting with beneficiaries and family members to provide them with the support and information they need throughout the claim process. Your role will be pivotal in ensuring that customers receive a high level of service that aligns with Prudential Financial's commitment to being customer-obsessed.

The team you will be joining is part of the U.S. Back Office Customer Service (BOCS) organization, which is undergoing a transformation to become more customer-centric. This transformation is driven by a future-state vision that emphasizes the importance of digital skills, empathy, and a willingness to help others. The ideal candidate will embody these values and be able to contribute to a culture that is entrepreneurial, adaptable, and focused on delivering exceptional customer experiences.

What You Will Do

• Review claims and extract information for processing, ensuring all necessary details are accurately captured.
• Spend a portion of your day on an incoming call line, assisting beneficiaries and family members with their questions and providing updates on claim status.
• Be flexible and available for evening phone coverage on a rotating basis to ensure continuous support for customers.
• Collect information and process death claims, verifying, correcting, and completing claims information through various means such as telephone, letter, or personal contact.
• Conduct investigations and gather supporting documentation on claims to make informed decisions.
• Calculate benefits payable and approve or deny claims in accordance with established procedures and regulatory guidelines.
• Work collaboratively with internal and external partners to obtain necessary information for claim handling.
• Utilize Prudential Financial's claim system and stay updated on products, policies, and procedures to effectively assist customers.

What We Are Looking For

• Entrepreneurial mindset with the ability to keep long-term goals in sight while tackling day-to-day challenges.
• Creative problem-solving skills, with the ability to evaluate situations from all angles and propose innovative solutions.
• Motivated self-starter who is enthusiastic about challenges and leads by example.
• Versatile communicator and collaborator who can adapt their style to build a cohesive team and maintain progress.
• High awareness of how different individuals and groups react to changes and the ability to anticipate future needs.
• Persuasive communication skills to get team members and business partners on board with vision and execution objectives.
• Intelligent risk-taker who can evaluate situations, understand challenges, and make necessary decisions to complete tasks.
• Decisive decision-maker who can make choices that move work forward.
• Takes ownership of work with a low ego, authentic, thoughtful, fair, and high integrity approach.

Nice to Have

• Experience in a similar role within the insurance industry, particularly in claims examination.
• Certification in insurance or a related field, demonstrating a commitment to professional development.
• Familiarity with digital tools and systems used in claims processing, with a willingness to learn and adapt to new technologies.

Benefits and Perks

• Competitive compensation package, reflecting the importance of this role within the organization.
• Comprehensive health insurance, recognizing the value of employees' well-being.
• Generous PTO policy, allowing for a healthy work-life balance.
• Remote work arrangement, providing autonomy and flexibility.
• Ongoing training and development opportunities, supporting career growth and skill enhancement.
• Access to a collaborative and dynamic team environment, fostering innovation and camaraderie.

• Ensure your resume highlights customer service skills and experience in claims examination or a related field.
• Develop a portfolio or prepare examples that demonstrate your ability to handle complex claims and provide excellent customer service.
• Familiarize yourself with common digital tools used in the insurance industry to show your adaptability and willingness to learn.
• During the interview, emphasize your entrepreneurial mindset, problem-solving skills, and ability to work in a fast-paced environment.
• Prepare questions to ask the interviewer about the company culture, team dynamics, and opportunities for growth and development.
• Consider negotiating remote work stipends or additional benefits that support your productivity and well-being in a remote setting.
• Be prepared to discuss your approach to handling sensitive and emotional situations, demonstrating empathy and professionalism.