MetLife · 6 hours ago
SR LTD Change in Definition Claims Specialist
United States
Full-time
Remote
Mid, Senior Level
$58K/yr - $69K/yr
3+ years expMetLife is one of the world’s leading financial services companies, providing insurance, annuities, employee benefits, and asset management. The Senior LTD Change in Definition Claims Specialist evaluates long term disability insurance claims, managing a complex caseload and conducting transition reviews to assess claimants' eligibility and ability to perform gainful occupation.
Asset ManagementFinancial ServicesInsuranceLife InsuranceRisk Management
Responsibilities
Effectively and independently manages an assigned caseload of complex claims within the change in definition (CID) lifecycle
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
Interacts and communicates effectively with claimants, customers, health care providers, 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 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 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
Qualification
Required
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
Ability to effectively manage multiple systems and technology resources
3+ years of LTD/IDI Insurance Claims experience
Preferred
Bachelor's degree
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
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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