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Long Term Disability Claims Specialist II

MetLife • Full-time • Remote (US) • $50k - $55k / year • 3m ago

Location(s)

Posting Location: Cary, North Carolina

Posting Location: Aurora, Illinois

Posting Location: Oriskany, New York

Posting Location: Tampa, Florida

Posting Location: Bloomfield, Connecticut

Country

United States

Working Schedule

Full-Time

Commutable Distance Required

Yes

Relocation Assistance Available

Posted Date

14-Aug-2024

Job ID

4061

Description and Requirements

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

Job Location: Virtual but must be commutable to Oriskany NY, Bloomfield CT, Aurora IL, Cary, NCor Tampa, FL offices.

Key Responsibilities:

Virtual roles predominately work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc.
Effectively manages with some level of oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators
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
Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills
Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations
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
Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions.
Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed
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
Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination.
Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas.

Essential Business Experience and Technical Skills:

Required:

New hires should live a commutable distance from the site the role is posted in.
Prior experience with independent judgement and decision making while relying on the available facts
Be able to demonstrate the use of critical thinking and analysis when reviewing the information
Creative problem-solving abilities and the ability to think outside the box
Excellent interpersonal and communication skills in both verbal and written form
Excellent customer service skills proven through internal and external customer interactions
Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively
Organizational and time management skills

Preferred:

Bachelor’s degree
1-3 years of LTD/IDI Insurance Claims experience

The salary range for applicants for this position is $50,000.00 - $55,000.00.

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 2024 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 accommodations@metlife.com. 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.

$50,000.00 - $55,000.00

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