MetLife Long Term Disability Specialist Trainee in Oriskany, New York
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist Trainee 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.
•Effectively manages an assigned caseload with supervision which consists of pending, ongoing/active and appeal reviews. The trainee will be routinely evaluated for increases in their authority levels as they become more experienced in their decision-making and demonstrate consistency in meeting all key performance indicators. It is expected that the trainee will be promoted to LTD CS within 4-6 months following the post-training period depending on prior related experience and evidence that the trainee is demonstrating the appropriate skill set in line with expectations.
•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
•Conducts lengthy detailed information-gathering telephone calls with claimant’s or their representatives to obtain medical condition details, financial details, occupational details and other information pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the facts of the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skills
•Interacts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluations
•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
•Collaborates with both external and internal resources, such as physicians, attorneys, clinical and vocational consultants, as needed, to gather data such as medical/occupational information in order to ensure reasonable, thorough decisions
•Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed
•Proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine payments
•Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination
•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
•Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint or litigation support areas
Essential Business Experience and Technical Skills:
•Prior experience with independent judgement and decision making while relying on the available facts.
•Be able to demonstrate the use of critical thinking and analysis when reviewing the information.
•Creative problem-solving abilities and the ability to think outside the box.
•Excellent interpersonal and communication skills in both verbal and written form.
•Excellent customer service skills proven through internal and external customer interactions
•Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively
•Organizational and time management skills
• Bachelor’s degree
• 1-2 years of related professional business experience.
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.
We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife. For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.
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 #: 120079
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