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Appeals Specialist - Long Term Disability

Date Posted: Nov 19, 2021

Location: Oriskany, NY, US, 13424

Company: MetLife

   

Job Location: United States : New York : Oriskany 

Alternate Job Location: Not Applicable : Not Applicable || United States : Florida : Tampa || United States : Illinois : Aurora

                                                   

Key Responsibilities: 

  • Reviews Disability Appeals by completing a fair, independent assessment and a thorough holistic review of the file and by assessing the denial or termination of a Disability claim for accuracy by evaluating plan provisions, medical and vocational information.

 

  • Uses experience and independent judgment to conduct comprehensive reviews and analysis of denied and terminated Disability claims for accuracy of determinations by taking into consideration contract provisions, medical, vocational and employment information

 

  • Uses independent judgment to identify additional aspects of the claim needing clarification of information, taking into consideration contract provisions and medical and vocational evidence of the claim and uses discretion to engage necessary resources, as deemed appropriate to the case.

 

  • Gathers additional facts and data during the course of the investigation for further consideration as warranted

 

  • Relies on experience and judgment to Conduct timely reviews in accordance and compliance with MetLife’s Administrative Guidelines and ERISA regulations. 

 

  • Formulates, articulates and documents the rationale for the appeal decision based on the facts of the claim.

 

  • Uses experience and independent judgment to prepare clear and concise written correspondence with claimants, policyholders, and attorneys in a timely manner.

 

  • Responds to all inquiries in a timely manner.

 

  • Identifies/address trends/opportunities to support efficiencies and ongoing process improvements..

 

  • Provides feedback to business partners where training or change in processes may be needed to improve individual, team, customer, business results.   

 

  • Performs other related duties and tasks as assigned.

 

Essential Business Experience and Key Behaviors:

Bachelor’s degree or equivalent business experience

5+ years disability claims experience

Thorough knowledge of STD/LTD, Workers Compensation, Social Security, ERISA and state laws

 

Competencies: Focuses on customers, Produces results

 

Salary Grade 

08M- Salaried

  

Travel 

0-5%  

Business Category 

Global Technology & 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:

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 help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.

 

We are one of the largest institutional investors in the U.S. with $642.4 billion of total assets under management as of March 31, 2021. We are ranked #46 on the Fortune 500 list for 2021. In 2020, we were named to the Dow Jones Sustainability Index (DJSI) for the fifth year in a row. DJSI is a global index to track the leading sustainability-driven companies. We are proud to have been named to Fortune magazine's 2021 list of the "World's Most Admired Companies." 

       

MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.

 

 

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife.  For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.

 

 

MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to 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.

 

 

Requisition #: 121073

 


Nearest Major Market: Utica