Senior Short-Term Disability Claim Specialist

Senior Short-Term Disability Claim Specialist at MetLife

As a Senior Short-Term Disability Claim Specialist, you will be the claim owner and decision-maker, responsible for administering claims within contractual provisions and internal/external guidelines. This role focuses on establishing a relationship with claimants to understand their perspective on their disability. Using this insight and other information, you will identify the claimant’s functional capacity and leverage it within the context of the contract to support and encourage return to work as appropriate.

Job Location

This team operates virtually within the US and will be working Pacific Time Zone Hours.

Key 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

Required

• 2 years of experience in Absence Management processing short-term disability, long-term disability claims, AMS, FLMA, ADA or PFML claims.
• 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.
• Critical-thinking skills.
• Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy.
• High School Diploma or GED Equivalent. This role has mandatory paid training starting on April 13th. Candidates must be available and present for all training days.

Preferred

• Ability to give and receive feedback to/from partners.
• Prioritization skills. Ability to balance quantity and quality.
• Basic knowledge of medical conditions, treatments, prognosis.
• College or University Degree.

About MetLife

At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers. 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.

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!

Key skills/competency

• Disability Claims
• Absence Management
• Contractual Provisions
• Return to Work
• Claim Administration
• Communication Skills
• Critical Thinking
• Strategic Thinking
• Medical Conditions Knowledge
• Customer Service