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Appeals Specialist - Short Term Disability

Date Posted: May 27, 2021

Location: Oriskany, NY, US, 13424 Tampa, FL, US, 33647 Aurora, IL, US, 60504

Company: MetLife

Job Location: Oriskany, NY   Alternate Locations: Tampa FL, Aurora, IL and 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 review Disability Appeals/Paid Medical Leave claims 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.

 

Key Responsibilities:

  • Reviews Disability Appeals/Paid Medical Leave claims 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.
  • Identifies 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
  • Conducts 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
  • Prepares clear and concise written correspondence with claimants, policyholders, and attorneys in a timely manner.
  • Responds to all inquiries in a timely manner.

 

Essential Business Experience and Technical Skills:
Required

  • 2-4 years of disability claims experience
  • Strong written and verbal communication skills
  • Thorough knowledge of STD/FML,PML, Workers Compensation, Social Security, ERISA and state laws
  • High School Diploma required

 

Preferred

  • Knowledge of writing letters
  • Bachelor’s Degree

 

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 $659.6 billion of total assets under management as of December 31, 2020. We are ranked #48 on the Fortune 500 list for 2020. 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.   

       

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.  Visit us at www.metlife.com to learn more about our brand, history, and values. 

 

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife.  If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to accommodations@metlife.com or call our Employee Relations Department at 1-877-843-3711.

 

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 #: 117523

 


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