Senior Product Claims Assistant - 4144

Description and Requirements
Global Customer Service and Operations serves MetLife's customers around the world, fulfilling their servicing, underwriting, policy administration and claims needs. We are guided by our purpose, putting the customer at the center of everything we do. As one team, we enable global consistency while addressing local needs to best support our markets. And, just like our customers are at the center, so are our people. Our teams' customer journey mindset ultimately fuels a contemporary customer experience, differentiating MetLife in the market.
Job Location: Must be commutable distance to MetLife Office in San Juan, Puerto Rico
In office once a month for office meetings
Role Value Proposition:
Provides exemplary internal support to group disability income insurance claims by processing/evaluating claims in a timely and accurate manner.
Key Responsibilities:
• Supports the claim adjudication team with the initial claim setup in accordance with the plan provisions, identifies potential recurrent claims and utilizes several systems to verify coverage
• Structures LTD claims based on claim receipt date
• Verifies disability coverage (STD/Statutory/LTD) through use of appropriate systems
• Inputs data and evaluates claimant eligibility via information received from claimant, physician, and employer.
• Follows established claim policies and practices to identify any potential claim issues
• Reviews claim detail and makes necessary outbound calls as needed
• Performs other related duties as assigned or required
Essential Business Experience and Technical Skills:
Required:
• High school diploma
• Excellent computer skills
• Critical thinking in activities requiring analysis and investigation
• Strong communications skills, both written and oral
• Ability to prioritize and maintain quality
Preferred:
• 2+ years relevant business experience
• Some college
• Basic knowledge of STD, LTD, group disability, workers compensation, ERISA, social security, and state laws
Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the 2024 "World's Most Admired Companies" as well as the 2024 Fortune 100 Best Companies to Work For ®, MetLife , through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by empathy, we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
Equal Employment Opportunity/Disability/Veterans
If you need an accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.
MetLife maintains a drug-free workplace.