Short Term Disability Claim Specialist

Role Overview

As a Short Term Disability Claim Specialist, you will serve as the claim owner and decision-maker, responsible for administering claims within contractual provisions and established internal and external guidelines. A key aspect of this role involves building relationships with claimants to understand their unique perspectives on their disability. Leveraging this understanding, along with other pertinent information, you will identify the claimant’s functional capacity and utilize it within the contract's framework to support and encourage a return to work when appropriate.

Job Location & Training

This position is virtual, requiring new hires to live within a commutable distance of Tampa, FL. Mandatory in-person training will be provided for up to 7 weeks.

Key Expectations

• Work from a home office, with periodic visits to the assigned GCSO office for team events, meetings, training, and business continuity.
• Apply all appropriate provisions of the disability contract to ensure MetLife’s liability is fully understood and correctly applied throughout the life of each claim.
• Within the context of liability, actively encourage and support claimants' return to work through various programs and methodologies.
• Proactively communicate with claimants to set expectations, assess medical and non-medical barriers to return to work, and keep them informed of their claim status, including if other resources (e.g., Vocational Rehabilitation) will be contacting them.
• Partner with claimants, specialty resources, and more experienced team members to ensure each claim has a clear, well-understood action plan tailored to the claimant’s unique situation, functional capacity, and prognosis.
• Execute individual claim action plans, serve as the primary point of contact for claimants, and make timely and accurate claim decisions.
• Manage an overall block of assigned claims, prioritizing actions, effectively utilizing resources, and ensuring timely and accurate decision-making.
• Provide a high level of service to claimants, including delivering on commitments, timely returning phone calls, and maintaining clear communication.
• Proactively update partners working with the claimant when key events are being considered or have occurred (e.g., claim closure, return to work).

Key Skills

Required

• Must live a commutable distance from Tampa, FL.
• 1-2 years of customer service experience, preferably in insurance claims (e.g., home, auto, life).
• A comprehensive understanding of disability contractual provisions, particularly the definition of disability.
• Strong communication skills, including the ability to dynamically interview claimants to set expectations and gather necessary claim information.
• Basic knowledge of medical conditions, treatments, and prognosis.
• Critical-thinking skills.
• Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy.
• High School Diploma or GED Equivalent.
• Availability for mandatory paid training starting April 13th.

Preferred

• 1-2 years of experience handling Absence Management Claims.
• Call center experience in an insurance setting.
• Prior experience with Short Term Disability (STD), Long Term Disability (LTD), Family and Medical Leave Act (FMLA), and/or Americans with Disabilities Act (ADA).
• Previous experience in claims management.
• Ability to give and receive feedback to/from partners.
• Prioritization skills.
• Ability to balance quantity and quality.
• College or University Degree.

About MetLife

MetLife is a leading global financial services company, recognized on Fortune magazine's list of the "World's Most Admired Companies," Fortune World’s 25 Best Workplaces™, and the Fortune 100 Best Companies to Work For®. We provide insurance, annuities, employee benefits, and asset management to individual and institutional customers across more than 40 markets. Our purpose is to help our colleagues, customers, communities, and the world create a more confident future, guided by our core values: Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead.

Benefits We Offer

Our comprehensive U.S. benefits package supports holistic well-being with programs for physical and mental health, financial wellness, and family support. This includes a health plan with medical/prescription drug and vision, dental insurance, no-cost short- and long-term disability, company-paid life insurance, legal services, a retirement pension funded by MetLife, and a 401(k) with employer matching. Employees also enjoy group discounts on voluntary insurance products, an Employee Assistance Program (EAP), digital mental health programs, parental leave, volunteer time off, tuition assistance, and more.

Key skills/competency

• Claims Administration
• Customer Service
• Disability Management
• Contractual Compliance
• Return-to-Work Programs
• Claimant Communication
• Critical Thinking
• Strategic Decision Making
• Medical Terminology
• Case Management