Job Classification:Operations – Insurance Operations

Job Description

The Absence Claim Examiner will be responsible for administering Family Medical Leave Act (FMLA) along with unpaid State leave policies and manage a block of claims. The Claim Examiner is accountable for ensuring optimal claims handling and timely, accurate decisions.

Responsibilities:

• Assists associates with leave of absence requests and guides them through the process

• Processes all leave of absence paperwork according to established procedures and laws

• Provides timely and accurate responses to associates and all levels of management concerning day-today issues and activities

• Administer the FMLA policy

• Review FMLA documentation for accuracy and completeness.

• Make recommendations to approve or deny requests for FMLA based on federal regulations.

• Coordinates correspondence, forms and other documents via the claim system

• Contact Providers for clarification

• Focus on customer experience to deliver the best experience for our customers

• Demonstrated ability to deliver accurate, dependable, and trustworthy service to our customers.

JOB REQUIREMENTS:

• 1 year in Short Term Disability, Absence, or Paid Leave claim management, or related health claim field experience desired.

• Claim/risk management skills and technical knowledge in contract interpretation and administration

• Ability to work in a fast-paced environment

• Success in achieving Individual Development goals

• Goal oriented with an ability to organize and analyze information

• Strong critical thinking skills, communication, organization and time management skills

• Proven customer service skills

• Demonstrated ability to adapt to the changing needs of an organization

• PC skills required (i.e., Windows based environment; Word; Excel; PowerPoint)

Additional Requirements:

This position will work virtually; therefore new hires must be able to provide the following & all new hires who work remotely will be held accountable to these standards:

• Subscribe to internet service provider plan with at least 25 Mbps download speeds. You must be willing to troubleshoot any issues or outages with your home internet service, contacting your service provider as necessary.

• Must have the capability to handle calls with a cell phone (would need to have unlimited data and minutes) or a landline. Your personal phone number will not be identified to customers.

• Quiet area in your home with minimal distractions and noise free.

• Reliability and Dependability throughout our extensive training program is required

At Prudential, you can:

Take charge of your career. We equip and empower our employees to expand their skills and experience by using powerful learning, gigs, and job opportunities. We offer a suite of services including 1:1 Career advice, on demand resources and networking to propel your career forward. We’re a global organization, full of outstandingly dedicated people who aren’t afraid to think differently, challenge the status quo and take sensible risks along the way. You will enjoy pushing boundaries as we build innovative technology that helps clients, customers and employees live their best lives. You will have access to leadership and learning opportunities and the resources needed to take your career in any direction. We will help you do your best work, offering flexibility, while delivering on our Purpose.

What we offer you:

Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $42,000.00 to $69,300.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.

• 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 Programsincluding 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. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.  

Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom. 

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

If you need an accommodation to complete the application process, please email [email protected]. 

If you are experiencing a technical issue with your application or an assessment, please email [email protected] to request assistance.