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Total Absence Management Claims Support Specialist

Date Posted: Jan 20, 2022

Location: Oriskany, NY, US, 13424

Company: MetLife

Role Value Proposition: 

Provides exemplary customer service by managing total absence claims in a timely and accurate fashion.

    

Key Responsibilities:  

Conducts a fair, thorough, independent, holistic review, and articulates and documents the rationale for the appeal decision. Identifies additional aspects of claims and gathers additional facts and data. Responds to all inquiries in a timely manner with clear and concise responses. Manages an assigned caseload of the most complex claims. Develops and maintains strong working relationships with internal and external customers. In addition:

  • Evaluates and improves business processes by effectively conducting a statistically valid sample of quality evaluations.
  • Acts as an expert in administration of standalone FMLA leaves, Paid Family Leaves, ADA and other leaves in adherence to federal, state regulations and company plans.
  • Analyze, identify and implement strategies to enhance claim management, customer centricity and efficiency.
  • Audit claim files and monthly call monitoring to identify improvement opportunities.
  • Supports and guides team members to meet or exceed regulatory and compliance requirements.
  • Reviews and approves key decisions made by team members.
  • No formal supervisory responsibilities but requires ability to lead and motivate team members as well as providing work direction to lower-level staff members.
  • Performs other duties as assigned or required.

 

Essential Business Experience and Technical Skills:

Strong knowledge of STD, LTD, group disability, workers compensation, ERISA, social security, and state laws. Strong customer focus and management. Basic knowledge of multiple systems and technology resources.

 

5+ years,BA .

 

Required:

  • High School diploma
  • 7+ yrs. related experience in claims or customer service

Preferred:

  • Bachelor’s degree
  • Solid business knowledge of TAM products.
  • Proficient in use of multiple systems and technology resources.
  • Ability to read, interpret and explain contracts and TAM plans.
  • Strong customer satisfaction focus. 

 

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.  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.


Nearest Major Market: Utica