Job Overview
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Job Description
Role Summary
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist I evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Specialist is required to exercise critical thinking skills, exemplary customer service skills as well as effective inventory management skills with oversight and expected progression to a LTD Claims Specialist II role.
Job Location
Virtual, but must be commutable to any of the following office locations: Oriskany, NY; Cary, NC; Bloomfield, CT; Aurora, IL. Employees are required to come into the office for training. After training, employees are to report to the office 1x a month.
Key Responsibilities
- Effectively manages an assigned caseload, which consists of pending and ongoing/active reviews.
- Provides timely, balanced, and accurate claims reviews, documentation, and recommended decisions in accordance with regulations.
- Identifies return to work potential and develops action plans.
- Communicates proactively with claimants and/or their representatives, providing clear updates and explanations regarding the claim process and benefits.
- Documents all conversations and claim file information with professional writing skills.
- Collaborates with internal and external resources, such as physicians, attorneys, and consultants, to gather necessary data for claim evaluations.
- Addresses and resolves escalated customer complaints in a timely and thorough manner.
- Identifies and refers appropriate matters to appeals, complaint, or litigation support areas.
Essential Business Experience and Technical Skills
Required:
- New hires should live a commutable distance from the posted job site.
- High School Diploma.
- Minimum 2 years of experience in external customer service or related experience.
- Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
- 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.
- Organizational and time management skills.
Preferred:
- Bachelor’s degree.
Business Category
Operations - Claims
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!
Key skills/competency
- Long Term Disability Claims
- Claims Evaluation
- Customer Service
- Critical Thinking
- Inventory Management
- Communication Skills
- Problem-Solving
- MetLife
- Insurance
- Operations
How to Get Hired at MetLife
- Tailor your resume: Highlight customer service, claims analysis, and critical thinking experience relevant to MetLife's Long Term Disability Claims Specialist role.
- Showcase communication skills: Emphasize your ability to communicate complex information clearly and empathetically, both verbally and in writing, in your application.
- Quantify achievements: Use numbers to demonstrate your success in managing caseloads, meeting service standards, or resolving customer issues.
- Prepare for interviews: Be ready to discuss how you apply critical thinking and problem-solving in claims assessment and customer interactions.
- Research MetLife: Understand their values and mission to align your answers with the company culture during the interview process.
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