Specialist, Virtual Health

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!

The Long-Term Disability Core Team, within the Group Insurance Disability Organization, is seeking an experienced and highly motivated individual to join the team as a Disability Claims Specialist . The successful candidate will serve as a Long Term Disability technical expert, applying deep claim management knowledge and sound judgment to guide claim professionals, support the Team Lead, and promote consistent, high-quality claim outcomes.

This role supports the Team Lead by serving as a technical and consultative resource to the team. Key responsibilities include providing technical guidance, coaching, and actionable feedback; consulting on complex or high-risk claim matters; and helping prioritize actions needed to maintain claim block health. The role strengthens claim professional capability and decision quality while claim ownership and execution remain with the assigned claim professional.

• Serve as a Long Term Disability technical expert and trusted resource to the Team Lead and claim professionals on complex claim management matters.
• Provide technical guidance on policy interpretation, medical and vocational considerations, claim strategy, benefit eligibility, and appropriate next steps.
• Coach claim professionals through complex claim scenarios, strengthen critical thinking, and reinforce consistent, effective claim management practices.
• Provide timely, actionable feedback that builds technical capability, improves execution, and supports sound claim decisions.
• Analyze claim activity and outcomes to identify trends, emerging risks, and opportunities for targeted coaching, process improvement, or escalation.
• Partner with the Team Lead to monitor and maintain claim block health by analyzing inventory and performance indicators, identifying areas of risk, recommending priorities, and supporting timely follow-through on corrective actions.
• Support the development and delivery of technical training, knowledge sharing, and skill-building activities for claim professionals.
• Provide consultation on high-risk, escalated, or technically complex claims by identifying key considerations and recommending approaches aligned with policy provisions, procedures, and sound Long Term Disability claim management practices.
• Support additional technical, coaching, analytical, and operational priorities as assigned based on evolving team and business needs.

• Minimum of 3 years of Long-Term Disability claim management experience, with demonstrated technical expertise in complex claim evaluation, consultation, and resolution.
• Advanced knowledge of Long-Term Disability policy provisions, medical and vocational considerations, benefit calculations, Social Security benefits, and other deductible sources of income.
• Proven ability to independently analyze complex or high-risk claim scenarios, identify key issues, and recommend sound claim strategies and next steps.
• Demonstrated success coaching claim professionals, providing actionable feedback, and building technical capability and critical-thinking skills.
• Ability to interpret claim data, inventory indicators, and activity trends to identify emerging risks and recommend actions that improve claim quality, consistency, and block health.
• Ability to adapt technical support, coaching, and priorities to meet changing team, claim block, and business needs.
• Proficiency in Microsoft Teams, Word, and Excel, including using data and…