Be an early applicantLess than 25 applicants

Company

MetLife · 7 hours ago

Lead Long Term Disability Claims Specialist

United States

Full-time

Remote

Senior Level

$50K/yr - $75K/yr

5+ years exp

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Asset ManagementFinancial Services

H1B Sponsor Likely

Hiring Manager

Feroz Abdul Hadhi

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Responsibilities

Independently manage an assigned caseload of the most complex claims which consists of pending, ongoing/active and appeal reviews. 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 timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination and 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. 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.

Collaborates effectively with both external and internal resources, such as physicians, attorneys, vocational consultants and CPAs, 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 and addresses/resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas.

Serves as an extended leadership team member, participates in new hire onboarding including coaching, mentoring and development, providing direct support to Unit Leaders, and partners with the leadership team to meet project goals related to quality, timely claim outcomes, customer service and staff development and provide detailed, balanced feedback to leadership on individual, team, customer or site performance and offers solutions on opportunities identified.

Qualification

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LTD/IDI Insurance ClaimsSTD/FML KnowledgeState Leave LawsWorker’s CompensationERISA KnowledgeSocial Security Knowledge

Required

5+ years of LTD/IDI Insurance Claims experience with excellent customer service skills proven through internal and external customer interactions

Prior experience with independent judgement and decision making while relying on the available facts/problem solving/critical thinking

Ability to effectively manage multiple systems and technology resources

Organizational and time management skills

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

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

Represents job field similar to this job

Trends of Total Sponsorships

2023 (61)

2022 (165)

2021 (96)

2020 (78)