Joseph Jones Jr.
Atlanta,GA
Summary
Results-driven and seasoned insurance professional with 10+ years of experience and a proven track record in leading and managing Long Term Disability claims teams for industry leaders such as MetLife, Prudential, Anthem Life Insurance, and Harvey W. Watt & Company. Highly skilled in compiling and analyzing detailed file documentation, making logical claims determinations, and calculating complex monthly benefits. Adept at collaborating with external and internal stakeholders, including physicians, attorneys, and vocational consultants, to ensure thorough decisions.
Overview
12
12
years of professional experience
Work History
Investor Services Representative
Joemar Property Solutions
Atlanta, Georgia
10.2023 - 03.2025
- Met with members to understand goals and recommend solutions to fit specific needs.
- Discussed financial options with clients and provided informed suggestions.
- Prepared contracts and related documentation according to strict standards.
- Worked with clients to develop financial planning strategies and solutions through evaluation of finances.
Lead Long Term Disability Claims Specialist
MetLife Insurance Company
12.2022 - 09.2023
- Compiled comprehensive file documentation and correspondence, ensuring detailed policy adherence.
- Analyzed information to make reasoned and logical claims determinations, calculating monthly benefits with precision, including COLA, Social Security Offsets, and Rehab Return to Work benefits.
- Collaborated seamlessly with external and internal stakeholders, including physicians, attorneys, and vocational consultants.
- Resolved escalated customer complaints promptly, referring appropriate matters to appeals or litigation support areas.
- Played a key role in the leadership team, contributing to new hire onboarding, coaching, mentoring, and staff development.
Senior Long Term Disability Claims Examiner
Prudential Life Insurance
05.2022 - 09.2022
- Managed 100 Long Term Disability (LTD) claims, demonstrating excellent customer service.
- Assessed risk liability, reviewed medical records, and collaborated with various business partners for claim decisions.
- Communicated effectively with claimants, employees, employers, attorneys, and other stakeholders.
- Applied policy plan provisions, documented claim information concisely, and completed financial calculations.
Life and Disability Claims Team Lead
Anthem Life Insurance Company
03.2021 - 03.2022
- Managed a team of 6-8 LTD Claims Consultants, overseeing training and resolving escalations.
- Collaborated with leadership to ensure adherence to disability policy coverage guidelines.
- Administered disability income payments, monitored benefit reductions, and ensured compliance with relevant regulations.
Long Term Disability Claims Team Lead
Harvey W. Watt & Company
06.2018 - 12.2020
- Led a team of 10 LTD Claims Consultants, focusing on coaching, development, and onboarding.
- Evaluated new business initiatives for processing improvement opportunities.
- Functioned as a liaison during project implementation, addressing client concerns and facilitating regular meetings.
Quality Assurance Analyst
Harvey W. Watt & Company
04.2016 - 06.2018
- Conducted monthly audits of LTD disability claims for accuracy and proficiency.
- Collaborated with the leadership team to address trends and findings.
- Prepared audit reports and created tracking tools to improve audit efficiencies.
Senior Long Term Disability Claims Consultant
Harvey W. Watt & Company
05.2013 - 04.2016
- Managed 150-200 LTD claims, reviewing plan documents and policies for coverage confirmation.
- Mentored newly promoted or transitioning LTD Claims Consultants.
- Conducted interviews and obtained statements to secure necessary claim information.
Education
BACHELOR OF SCIENCE - Healthcare Management
Clayton State University
Morrow, GeorgiaSkills
- Case Management
- Claims Management & Adjudication
- Client Relationship Management
- Compliance Monitoring
- Customer Service
- Financial Analysis
- Leadership and Team Management
- Policy Interpretation
- Problem Resolution
- Project Management
- Quality Assurance and Auditing
- Regulatory Compliance
- Reporting & Analysis
- Training and Development
References
Available Upon Request
Timeline
Investor Services Representative
Joemar Property Solutions
10.2023 - 03.2025
Lead Long Term Disability Claims Specialist
MetLife Insurance Company
12.2022 - 09.2023
Senior Long Term Disability Claims Examiner
Prudential Life Insurance
05.2022 - 09.2022
Life and Disability Claims Team Lead
Anthem Life Insurance Company
03.2021 - 03.2022
Long Term Disability Claims Team Lead
Harvey W. Watt & Company
06.2018 - 12.2020
Quality Assurance Analyst
Harvey W. Watt & Company
04.2016 - 06.2018
Senior Long Term Disability Claims Consultant
Harvey W. Watt & Company
05.2013 - 04.2016
BACHELOR OF SCIENCE - Healthcare Management
Clayton State University
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