Short Term Disability Claim Specialist
Indexed description
The Opportunity
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.
Key Responsibilities
- 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. Proactively updates partners that may be working with the claimant when key events are being considered or have occurred. (closure, RTW, etc.).
- Manages overall block of assigned claims, including prioritizing actions, appropriately utilizing resources, and timely and accurate decision. Executes individual claim action plans, serves as point of contact for the claimant, and makes claim decisions.
- Provides a high-level of service to the claimant, including delivering on commitments, timely return of phone calls, and clear communication.
- New hires should live a commutable distance from the site the role is posted in.
- Oriskany NY, Bloomfield CT, Tampa FL, Cary NC
- High school diploma or GED equivalent.
- A comprehensive understanding of the disability contractual provisions, especially the definition of disability.
- Strong communication skills, including the ability to coach Case Specialist to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim.
- Critical-thinking, strategic-thinking, and prioritization skills
- Ability to give and receive feedback using specific measurements and observed behavior as well as openness to receiving feedback
- Associate Degree
- 1+ years of claims management experience preferably in Healthcare field
- Proficiency in Microsoft Word/Excel
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World’s 25 Best Workplaces™, as well as the 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 our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we’re inspired to transform the next century in financial services. At MetLife, it’s #AllTogetherPossible. Join us!
MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law (“protected characteristics”).
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.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
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