Senior Short Term Disability Claim Specialist - 11.4.24

Description and Requirements
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Global Technology & Operations group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to create innovative and solutions to address core business challenges with MetLife. This role will provide exemplary customer service by processing group disability claims in a timely and accurate fashion.
Job Location: Virtual
Role Overview:
Claim owner and decision-maker. Responsible for administering claims within contractual provisions and internal /external guidelines. Establishes a relationship with claimants in order to understand their perspective on their disability. Using that perspective and other information, identifies the claimant's functional capacity and leverages that capacity within the context of the contract to support and encourages return to work as appropriate.
K ey expectations:

• Applies all appropriate provisions of the disability contract to ensure that MetLife's liability is understood and appropriately applied throughout the life of the claim. Within the context of liability, encourage and support return to work through a variety of programs and methodologies.
• Proactively communicates with the claimant to set expectations, assess medical and non-medical barriers to return to work, and keep him or her fully aware of the status of the claim, including setting expectations with the claimant if other resources (Voc, etc.) will be contacting him/her.
• Partners with the claimant, specialty resources, and more experienced resources to ensure that each claim has a well-understood plan that is appropriate for the unique situation of each claimant, his or her functional capacity and the prognosis for an increase in that capacity.
• Executes individual claim action plans, serves as point of contact for the claimant, and makes claim decisions.
• Manages overall block of assigned claims, including prioritizing actions, appropriately utilizing resources, and timely and accurate decision.
• Provides a high-level of service to the claimant, including delivering on commitments, timely return of phone calls, and clear communication.
• Proactively updates partners that may be working with the claimant when key events are being considered or have occurred. (closure, RTW, etc.).

Key skills:

• A comprehensive understanding of the disability contractual provisions, especially the definition of disability.
• Strong communication skills, including the ability to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim.
• Basic knowledge of medical conditions, treatments, prognosis
• Critical-thinking skills
• Ability to give and receive feedback to/from partners
• Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy
• Prioritization skills. Ability to balance quantity and quality.

Requirements:

• Must have 1-2 years of STD claims experience

Key Competencies, Qualifications and Skills, Preferred :

• Associate Degree or higher
• 2 plus years of claims management experience preferably in Healthcare field
• Proficient with Microsoft office software
• Prior STD and Family Medical Leave Act claims knowledge
• Ability to work independently
• An understanding of disability contractual provisions

The salary range for applicants for this position is $41,600.00 - $59,000.00.
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.
$41,600.00 - $59,000.00