Appeals Specialist Long Term Disability

MetLife; United States; On-site; USD 42,000 - 72,000; Full time

Benefits offered by this job

Health plan

Life Insurance

401(k) matching

Parental leave

Paid time off

Job summary

MetLife, a leading global insurer, seeks a Long-Term Disability Appeal Specialist to review denied claims and provide independent, holistic assessments based on plan provisions and historical data.

You will work with the Appeal team under ERISA guidelines, leveraging investigative skills to ensure accurate decisions while balancing regulatory compliance and customer service excellence.

Qualifications

• 3–5 years disability claim background, with preference for appeal handling.
• Excellent oral and written communication skills.
• Ability to multitask and manage competing priorities.

Responsibilities

• Manage claim files with accuracy, reviewing contract provisions, payment history, and clinical information.
• Research guidelines to ensure accuracy and adhere to ERISA requirements.
• Prepare clear written correspondence to claimants and policyholders in a timely manner.
• Coordinate with team members to distribute workload efficiently.
• Perform related duties as assigned.
• Occasional in-office attendance within 50 miles of MetLife offices (1x per month).

Skills

Disability claims

Communication

Multi-tasking

Relationship building

Adaptability

AI tools usage

Tools

Web-based systems

Job description

Join the nation’s largest non-medical carrier of group insurance, where your work will impact over 55,000 customers and cover more than 50 million employees and family members. As part of MetLife’s Group Benefits team, you’ll deliver innovative benefits solutions - life, disability, dental, vision, and voluntary benefits - tailored to today’s employers and workforces. Collaborate with customers, brokers, and partners to expand our offerings and reimagine digital experiences. Join us and be part of an organization committed to supporting customers when they need us most.

The Opportunity

• The Long-Term Disability Appeal Specialist is responsible for reviewing denied claims and complete a fair, independent assessment and a thorough holistic review of the file and assessing the claim for accuracy by evaluating plan provisions and services rendered along with historical research.
• You will follow State Regulations and ERISA guidelines when processing files. Keeping things timely to prevent risk.
• This is an exciting opportunity to utilize investigative skills, analysis data for accuracy and make a difference by providing the right decision.
• Success in this role requires attention to detail, ability to multi-task and engaging the right resources. The Disability Appeal Specialist is responsible for gather facts and data during the course of investigation for further consideration and follow ERISA guidelines.
• You’ll collaborate closely with members of the Appeal team, your team lead, and claim resources in an environment where every contribution is respected, and every perspective is heard.

Key Responsibilities

• Manage claim files with accuracy and conduct comprehensive review taking into consideration contract provisions, history of payment, plan limitations and clinical information with ability to research guidelines for accuracy.
• Caseload Management across multiple systems in order to make timely decisions according to ERISA.
• Create and prepare clear and concise written correspondence where applicable with claimants, policyholders in a timely manner.
• Coordinate with other team members to move workload with a once and done concept.
• Perform related duties and task as assigned
• Candidates that are within 50 miles and commutable to a MetLife office will be required in-office 1x per month

Required Qualifications

• 3-5 years Disability Claim Background with preference in appeal handling
• Excellent communication skills (oral and written)
• Multi-tasking Skills
• Builds and maintains strong relationships with direct team and other internal partners
• Willingness to accept change and provide constructive feedback where applicable.
• Leverages approved AI and automation tools to efficiently analyze and summarize complex claim files, enhance claim analysis, support informed decision-making, improve productivity, and deliver a high-quality customer experience while exercising independent judgment and maintaining regulatory, compliance, and data privacy standards

Preferred Qualifications

• Ability to utilize and manage different web-based systems.
• Understanding of Disability plans
• Ability to perform in a production environment.
• Team player

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 make a difference in the lives of our customers.

The expected salary range for this position is $41,600 - $72,300.

This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.

Benefits We Offer

Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, paid time off, paid holidays, volunteer time off, tuition assistance and much more! For more information regarding MetLife’s U.S. benefits, please.

About MetLife

Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World’s 25 Best Workplaces™, as well as the Fortune 100 Best Companies to Work For®, 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 individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

As part of our New Frontier strategy, MetLife is building an AI-enabled, people-centered future. We’re looking for people who bring curiosity, adaptability, and a growth mindset as we use AI to enhance how we serve customers, support communities, and evolve the way work gets done. At MetLife, AI is a responsible partner that supports human judgment, creativity, and continuous improvement while helping us build trust, inclusion, and long-term value.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we’re inspired to transform the next century in financial services. At MetLife, it’s #AllTogetherPossible. Join us!

MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law (“protected characteristics”).

If you need an accommodation due to a disability, please email us at [e-mail]. 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.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.

This posting is for a current vacancy and is anticipated to remain open for at least 14 days from the listed posting date.