Disability Claims Specialist - Hybrid & Impactful Care

MetLife; Omaha (NE); Hybrid; USD 42,000 - 72,000; Full time

Benefits offered by this job

Health plan

Life insurance

401(k) with employer matching

Paid time off

Job summary

MetLife’s Global Customer Service and Operations is seeking a claims professional to process STD/LTD disability claims with accuracy and empathy. This hybrid role requires commuting to designated locations and monthly in-office meetings, offering a comprehensive benefits package.

You will assess claims, gather medical information, determine liability, and clearly communicate decisions to claimants and providers, leveraging AI tools to improve speed and quality of daily tasks.

Qualifications

• Must live within commutable distance of an MetLife office (locations listed) and be able to commute.
• In-person meetings required once a month.
• High School Diploma required.
• 2+ years of short-term disability (STD) experience.
• Knowledge of disability insurance, written and verbal communication.
• Ability to use AI to improve speed, quality, and efficiency across tasks.

Responsibilities

• Independently assess, analyze, and render appropriate claim decisions on STD, PML, and state claims.
• Clarify functional capacity through independent problem-solving and information gathering.
• Adhere to federal and state laws to maintain timely claim outcomes.
• Communicate clearly to influence return to work and explain payment decisions.
• Engage with claimants, doctors, nurses, employers, and attorneys to gather relevant information.
• Document rationale for claim direction and act within or beyond CMG guidelines as justified.
• Utilize tools to identify work, prioritize tasks, and involve specialty resources when needed.
• Determine return-to-work potential and likely claim progression based on facts.
• Perform other duties as required.

Skills

Written communication

Verbal communication

AI usage

Disability insurance knowledge

Education

High School Diploma

Tools

Claims processing software

AI tools

Job description

MetLife’s Global Customer Service and Operations is seeking a claims professional to process STD/LTD disability claims with accuracy and empathy. This hybrid role requires commuting to designated locations and monthly in-office meetings, offering a comprehensive benefits package.

You will assess claims, gather medical information, determine liability, and clearly communicate decisions to claimants and providers, leveraging AI tools to improve speed and quality of daily tasks.