MetLife · 1 day ago
Long Term Disability Claims Specialist II
United States
Full-time
Remote
Entry Level
$42K/yr - $62K/yr
1+ years expMetLife is a leading financial services company dedicated to making a meaningful impact in the lives of customers and communities. The LTD Claims Specialist II evaluates long term disability insurance claims, exercising independent judgment and critical thinking while ensuring exemplary customer service and effective inventory management.
Asset ManagementFinancial ServicesInsuranceLife InsuranceRisk Management
Responsibilities
Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc
Effectively manages with minimal oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active 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
Develop actions plans and identify return to work potential
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
Qualification
Required
High school diploma
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
Minimum 1 year LTD/IDI Insurance Claims experience
Preferred
Bachelor's degree
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
A 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
MetLife is a provider of insurance, employee benefits, and financial services .
10001+ employees
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
Represents job field similar to this job
Trends of Total Sponsorships
2025 (164)
2024 (108)
2023 (113)
2022 (155)
2021 (75)
2020 (81)
Funding
Current Stage
Public CompanyTotal Funding
$500M2024-06-20Post Ipo Debt· $500M
2000-04-14IPO
Leadership Team
Michel A. Khalaf
President & CEO, MetLife, Inc.
Koley Corte
Senior Vice President & Chief Marketing Officer - Institutional, Regional, Global Insights+Analytics
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