LTD Claims Specialist
Location:
Marlborough , Massachusetts
Posted:
December 20, 2016
Reference:
35361
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities.  In this role you will provide exemplary customer service by processing a case load of 90 - 100 group disability claims in a timely and accurate manner
Job Location                               
Marlborough, MA
Job Description          
  • 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.
Required Qualifications
  • 3-5 years of Long Term Disability experience
Preferred Qualifications
  • Strong communication skills, both written and oral
  • Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
Required Education
  • High School Diploma/GED
  • Bachelor's Degree preferred
Travel
0-5%
Business Category
Global Technology & Operations
Number of Openings
1
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.
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Internal Use Only: 07M  No Selection 


A little about us:
MetLife offers life insurance, disability income insurance, car insurance, employee benefits and more.

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