131 applicants

Company

MetLife · 4 hours ago

Sr LTD Claim Specialist, DCPU/NDS

United States

Full-time

Remote

Mid, Senior Level

$42K/yr - $72K/yr

3+ years exp

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H1B Sponsor Likely

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Responsibilities

Effectively and independently manages an assigned caseload of death claims.

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. 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 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 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.

Proficiently calculates death and survivor benefits due.

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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Claims managementLTD/IDI Insurance ClaimsPolicy knowledgeEmpathetic listening

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 and 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, and accident insurance

Employee Assistance Program (EAP) and 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

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Trends of Total Sponsorships

2023 (61)

2022 (165)

2021 (96)

2020 (78)