Senior Long Term Disability Claims Specialist

Senior Long Term Disability Claims Specialist

Country

United States

Working Schedule

Full-Time

Work Arrangement

Virtual

Commutable Distance Required

No

Relocation Assistance Available

No

Posted Date

08-Apr-2024

Job ID

2004

Description and Requirements

Job Location: 100% Virtual

Role Value Proposition:

At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Senior Long Term Disability (LTD) Claims Specialist evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the Senior LTD Claims Specialist is required to exercise independent judgment, critical thinking skills, exemplary customer service skills as well as effective inventory management skills.

Key Responsibilities:

• Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations while independently managing an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews

• Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during claim evaluations while addressing and resolving escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint or litigation support areas

• Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available and collaborates effectively with both external and internal resources, such as physicians, attorneys, clinical and vocational consultants, as needed, to gather data such as medical/occupational information in order to ensure reasonable, thorough decision

• Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed and proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine payments

Essential Business Experience and Technical Skills:

Required:

• 3+ years of LTD Insurance Claims experience

• Creative problem-solving abilities and the ability to think outside the box with independent judgement and decision making while relying on the available facts with the use of critical thinking and analysis when reviewing the information. Excellent interpersonal and communication skills in both verbal/written form and excellent customer service skills proven through internal/external customer interactions with demonstrated conceptual thinking, risk management, ability to handle complex situations effectively with organizational and time management skills

Preferred:

• Bachelor's degree and knowledge of STD/FML, state leave laws, worker's compensation, ERISA, and Social Security

The wage range for applicants for this position is $55,000.00 - $60,000.00. This role is also eligible for annual short-term incentive compensation. MetLife offers a comprehensive benefits program, including healthcare benefits, life insurance, retirement benefits, parental leave, legal plan services and paid time off. All incentives and benefits are subject to the applicable plan terms.

Benefits We Offer

Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!

About MetLife

Recognized on Fortune magazine's list of the 2023 "World's Most Admired Companies" as well as the 2023 Fortune 100 Best Companies to Work For ®, MetLife , through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by empathy, we're inspired to transform the next century in financial services. At MetLife, it's#AllTogetherPossible (~~~) . Join us!

Equal Employment Opportunity/Disability/Veterans

If you need an accommodation due to a disability, please email us at ~~~. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.

MetLife maintains a drug-free workplace.