Disability Appeals Specialist: Data-Driven Claims Analyst

MetLif; United States; Hybrid; USD 70,000 - 90,000; Full time

Job summary

MetLife is seeking a Long Term Disability Appeal Specialist to review denied claims, perform holistic assessments, and ensure accuracy by evaluating plan provisions, historical payments, and clinical data. You will work under ERISA guidelines to maintain timely processing and risk control while using AI tools to enhance analysis.

You’ll collaborate with the Appeal team and claim resources to deliver fair decisions, with a focus on attention to detail and effective communication across

Qualifications

• 3-5 years Disability Claim background, preference in appeal handling.
• Excellent communication skills (oral and written).
• Multi-tasking skills and collaboration with internal partners.
• Willingness to accept change and provide constructive feedback.
• Leverages approved AI and automation tools to analyze and summarize complex claim files.

Responsibilities

• Review denied disability claims and perform a fair, independent assessment.
• Follow ERISA guidelines and state regulations in processing files.
• Create clear written correspondence with claimants and policyholders.
• Coordinate with team members to balance workload and ensure timely decisions.
• Be prepared for in-office 1x per month if within 50 miles of a MetLife office.

Skills

Communication skills

Multi-tasking

Relationship building

Adaptability

AI tools usage

Tools

Automation tools

Job description

MetLife is seeking a Long Term Disability Appeal Specialist to review denied claims, perform holistic assessments, and ensure accuracy by evaluating plan provisions, historical payments, and clinical data. You will work under ERISA guidelines to maintain timely processing and risk control while using AI tools to enhance analysis.

You’ll collaborate with the Appeal team and claim resources to deliver fair decisions, with a focus on attention to detail and effective communication across