What are the responsibilities and job description for the Claims Specialist position at Tential?

Claims Specialist

Company Overview
Our Client is a leading provider of financial and insurance services, specializing in comprehensive pension plan management. Our cornerstone client requires dedicated support for the largest pension plan we service, necessitating a physical office in California.

Team Overview
Our team, consisting of 30-40 professionals including 5 managers, is responsible for servicing this critical pension plan. The team's focus areas include claims processing for short-term disability, long-term disability, retirement, and death claims. We prioritize efficiency, accuracy, and timely service delivery to meet our client's needs.

Job Overview
The Prudential Claims Specialist role is essential in handling retirement claims and processing financial transactions on behalf of clients. This position requires high multitasking abilities, problem-solving skills, and a strong background in finance or claims. Agents will work with mainframe systems and apply specific codes to ensure accurate payments. Initial tasks will include maintenance cases, such as address updates, before moving on to more complex claims.

Job Details

Position: Claims Specialist
Location: Hybrid (Work from Home and In-Office in Thousand Oaks, CA, Majority remote)
Working Hours: 8:00 AM - 4:00 PM PST
Lunch Break: 30 minutes
Other Breaks: Two 10-minute breaks
Overtime: Available after competency is demonstrated

Candidate Requirements
Educational Background

Technical Skills

Computer literate (Windows OS).
Experience with Prudential software is a plus.
Excel skills are beneficial but not primary; familiarity with templated worksheets is necessary.
Problem-solving abilities, especially related to connectivity and software issues.

Professional Experience

Claims experience, especially in life insurance or retirement, is ideal if you do not have a finance (Accounting, Econ, Math) related degree
Ability to handle high volumes of claims.
Multitasking capabilities and attention to detail.
Organizational skills and the ability to manage workflow efficiently.

Personal Attributes

Outgoing personality, not overly shy.
Strong communication skills.
High competency in their field, with a track record of dealing with complex tasks.
Willingness to be trained and adapt to new systems quickly.

Job Responsibilities

Initial Training: Focus on general maintenance cases (e.g., address updates).
Mainframe System Usage: Applying specific codes to generate accurate payments.
Claims Processing:
- Handling retirement claims dedicated to the largest client our customer supports.
- Ensuring quality and accuracy in processing money-out transactions.
Problem Solving: Addressing issues independently, especially technical problems.
Work Management: Efficient workflow handling and multitasking.

Detailed Responsibilities

Processing Claims:
- Review and process retirement claims.
- Ensure all claims are handled with the utmost accuracy and in a timely manner.
- Apply the correct codes in the mainframe system to generate payments.

Address Updates:
- Handle initial maintenance cases like address updates and other changes.
- Ensure these updates are correctly reflected in the system.

Client Interaction:
- Act as a liaison between the company and clients, providing updates and answering inquiries.
- Maintain professionalism and high standards of customer service at all times.

Documentation and Reporting:
- Keep accurate records of all claims processed and changes made.
- Generate reports as required for management review.

Continuous Improvement:
- Identify areas for improvement in the claims process.
- Suggest and implement process improvements to enhance efficiency and accuracy.

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