Claim Specialist of LTC, Legacy Business Solutions

Job Classification:

Operations - Insurance Operations

At Prudential, we believe talent is key to achieving our vision. When you join Prudential, you’ll unlock a motivating and impactful career – all while growing your skills and advancing your profession at one of the world’s leading financial services institutions!

Reporting directly to the Director of Long-Term Care (LTC) Operations, this role is responsible for the evaluation of LTC claim reviews and decisions. In addition to managing a caseload, this position offers the opportunity to identify trends to optimize the performance of the organization including providing feedback, initiating continuous improvement, and identifying training opportunities within the claim function.

The current employee work arrangement for this position is dependent on the business preferences and your location, potentially requiring your on-site presence on occasion at a Prudential office.

What you can expect:

• Full oversight of assigned caseload of long-term care claim reviews.

• Responsible for resolving complex claim issues.

• Support legal department with any litigation requests including depositions and serving as a corporate witness.

• Identify opportunities to improve customer service and operational claim efficiencies.

• Demonstrate excellent organizational and time management skills.

• Stay up to date on industry regulations and best practices related to long-term care insurance.

• Provides oversight of claim process being performed by Pru LTC Third Party Administrators and deliver feedback to appropriate parties as needed.

• Support ongoing strategic claim management initiatives including predictive analytics models.

What you’ll need:

• Degree in healthcare, nursing, or related field

• 10+ years in Long Term Care claims or similar experience including disability claims required.

• Ability to manage multiple claim reviews simultaneously, maintain detailed records, and meet deadlines.

• Demonstrated strong leadership and management skills, including analytical, organizational and problem-solving skills, which support sound decision making.

• Demonstrated superior customer service skills.

• Excellent communication skills and interpersonal skills, with the ability to collaborate effectively with both internal and external partners.

• Strong analytical skills and critical thinking skills required to review claim documentation, and make informed decisions based on findings.

• Ability to work independently to manage difficult interactions.

• Proficiency in Microsoft Office.

It’d be a plus if you had:

• LHCP certification a plus but not required

Prudential welcomes all applicants, even if you don't meet every requirement. If your skills align with the role, we encourage you to apply.

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 such as 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:

• 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

• Retirement plans: 401(k) plan with company match (up to 4%), company-funded pension plan

• Wellness Programs to help you achieve your wellbeing goals, 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.

• Tuition Assistance to help finance traditional college enrollment toward obtaining an approved degree, many accredited certificate programs, and industry designations.