Jobs - Claims Specialist - Chattanooga, United States - MetLife
Description
Job Description:
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities.
The LTD Claims Specialist evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards.
In this role, the LTD Claims Specialist is required to exercise independent judgment, critical thinking skills, exemplary customer service skills as well as effective inventory management skills.
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Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions.
These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim.
Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations
Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants as needed to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions.
Virtual roles predominately work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc.
Effectively manages with some level of oversight an assigned caseload of moderately complex claims which consists of pending, ongoing/active and appeal reviews.
Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations
Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available
Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed
Job Requirements:
Bachelor's degree
Creative problem-solving abilities and the ability to think outside the box
Prior experience with independent judgement and decision making while relying on the available facts
1-3 years of LTD/IDI Insurance Claims experience
New hires should live a commutable distance from the site the role is posted in.
Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively
Be able to demonstrate the use of critical thinking and analysis when reviewing the information
Organizational and time management skills
Excellent interpersonal and communication skills in both verbal and written form
Excellent customer service skills proven through internal and external customer interactions
Job Details:
Company:
MetLife
Vacancy Type:
Full Time
Job Location:
Chattanooga, TN, US
Application Deadline:
N/A
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