Senior Short Term Disability Claim Specialist
Requirements Description and Requirements The Team You Will Join On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement.
Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide. Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time.
The Opportunity The Short Term Disability Claim Specialist will be responsible for reviewing and assessment Disability claim come in for our customers. You will be reviewing medical documentation, on the phone with claimants/customers, and managing a caseload to ensure proper management of our procedures and policies to determine if a claim is payable.
You will be responsible for ensuring excellent communication, show critical thinking skills, and make over determinations on claims that are submitted for various medical conditions
Key Responsibilities K ey expectations:
- Virtual roles work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc
- 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.).
- High school diploma or GED equivalent.
- New hires should live a commutable distance from the site the role is posted in.
- 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 conditio ns, 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.
- Candidates MUST have one year of Short Term Disability Claims Management Experience
- This role has mandatory paid training starting on June 22nd lasting for up to 7 weeks. Candidates must be available and present for all training days
- 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.
