200+ applicants

Company

MetLife · 7 hours ago

Senior Long Term Disability Claims Specialist

United States

Full-time

Remote

Mid, Senior Level

$55K/yr - $65K/yr

3+ years exp

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H1B Sponsor Likely

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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

Qualification

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LTD Insurance Claims experienceCustomer service skillsTime management skillsSTD/FML knowledgeState leave laws knowledgeWorker’s compensation knowledgeERISA knowledgeSocial Security knowledge

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.

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

Benefits

Comprehensive health plan that includes medical/prescription drug and vision

Dental insurance

No-cost short- and long-term disability

Company-paid life insurance

Legal services

Retirement pension funded entirely by MetLife

401(k) with employer matching

Group discounts on voluntary insurance products including auto and home

Pet

Critical illness

Hospital indemnity

Accident insurance

Employee Assistance Program (EAP)

Digital mental health programs

Parental leave

Volunteer time off

Tuition assistance

Company

MetLife

Glassdoor

3.9

MetLife is a provider of insurance, employee benefits, and financial services .

Founded in 1868

New York, New York, USA

10,001+ employees

http://www.metlife.com

H1B Sponsorship

MetLife has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

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Trends of Total Sponsorships

2023 (61)

2022 (165)

2021 (96)

2020 (78)