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LTD Claims Specialist

Date Posted: Nov 29, 2017

Location: Marlborough, MA, US, 01752

Company: MetLife

Job Location: Marlborough, MA

 

Role Value Proposition: 

Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We’re looking for unique talent with fresh perspectives that can propel innovation. In this role you will provide exemplary customer service by processing group disability claims in a timely and accurate manner

Key Responsibilities:

  • Independently assess, analyze and render appropriate claim decisions pursuant to certificates.
  • Clarify functional capacity through independent problem solving measures and discretion (gathering medical, vocational, and other information, efficient use of resources, and action planning) sufficient to determine initial and ongoing liability.
  • Adhere to federal and state law to maintain appropriate and timely claim outcomes.
  • Communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis for payment/non-payment.
  • Communicate with a variety of constituents (for example, claimants, doctors, nurses, employers, and attorneys) to gather information relevant to assessing, analyzing and rendering decisions based on the provisions of the policy and their own discretion, with limited guidance by supervisory personnel.
  • Articulate and document their rationale for claim direction, possess the autonomy to take steps outside of CMG guidelines to the extent supported by documented rationale and the facts of the claim file.
  • Utilize tools independently and accurately to identify work to be completed across the entire claim block, prioritize work, determine if/when to involve specialty resources such as clinical staff to obtain additional information on a claim.
  •  As the sole owner of the LTD claim, determine return to work potential and strategy, identify a likely claim progression based on the facts of the claim and take action on their own assessment of the claim.
  • Perform other duties as required

Essential Business Experience and Technical Skills:
Required

  • 1-3 years of Insurance Claims experience
  • High School Diploma/GED

Preferred

  • Long Term Disability Experience
  • Strong communication skills, both written and oral
  • Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
  • Bachelor’s Degree preferred

     

 

 

Travel

0-5%

 

Business Category

Global Technology and Operations

Number of Openings

1

 

 

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.” 

 

 

MetLife is a proud equal opportunity/affirmative action employer committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. It is MetLife's policy to ensure equal employment opportunity without discrimination or harassment based on race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

MetLife maintains a drug-free workplace.

For immediate consideration, click the Apply Now button. You will be directed to complete an on-line profile. Upon completion, you will receive an automated confirmation email verifying you have successfully applied to the job.

Requisition #: 92103 


Nearest Major Market: Boston