STD / LTD Claim Specialist - Greater Denver Area, United States - MetLife

Description

Description and Requirements

Location:
Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC or Aurora, IL office

Role Value Proposition:

At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities.

The Global Technology & Operations group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to create innovative and solutions to address core business challenges with MetLife.

This role will provide exemplary customer service by processing STD/LTD disability claims in a timely and accurate fashion.


Key Responsibilities:

• Independently assess, analyze and render appropriate claim decisions on STD , LTD , PML and state claims
• 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 all associated claims, 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 .

Essential Business Experience and

Technical Skills:


Required:

• 
  Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT, Cary, NC or Aurora, IL office.
• High School Diploma
• 2+ years of short or long-term disability (STD/LTD) experience
• Experience using either DPA or Intellis systems

Preferred:

• Bachelor's degree
• Strong communication skills, both written and oral.
• Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
• Strong problem solving and analytical skills.

The wage range for applicants for this position is $41,600 - $68,100. This role is also eligible for annual short-term incentive compensation.

MetLife offers a comprehensive benefits program, including healthcare benefits, life insurance, retirement benefits, parental leave, legal plan services and paid time off.

All incentives and benefits are subject to the applicable plan terms.
MetLife maintains a drug-free workplace.

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.
Equal Employment Opportunity/Disability/Veterans

If you need an accommodation due to a disability, please email us at This information will be held in confidence and used only to determine an appropriate accommodation for the application process.

MetLife maintains a drug-free workplace.