Hybrid STD Claims Specialist – Make Real Impact

MetLife; San Juan (PR); Hybrid; USD 42,000 - 72,000; Full time

Benefits offered by this job

Health plan

Disability coverage

401(k) match

Life insurance

Paid time off

Job summary

MetLife’s Global Customer Service and Operations team seeks to improve customer care through trust and empathy while delivering efficient disability claim processing. The role focuses on timely STD/LTD claim decisions, using AI to enhance speed and accuracy, and collaborating with clinicians and attorneys across a hybrid work model.

You will work within a diverse GTO group focused on improving claims outcomes, serving customers and communities with professional, compliant communication and

Qualifications

• High School Diploma required. 2+ years of STD disability experience.
• Disability insurance knowledge, and strong written and verbal communication skills.
• Ability to use AI to speed up work and improve accuracy and efficiency.

Responsibilities

• Independently assess and render claim decisions on STD, PML, and state claims.
• Gather medical, vocational, and other information to determine liability.
• Maintain compliance with federal and state laws and communicate decisions clearly.
• Explain payment or non-payment bases and interlocution with claimants, doctors, and attorneys.
• Use tools to identify work, prioritize tasks, and involve clinical staff when needed.
• Determine return-to-work potential and draft claim progression plans.
• Perform other duties as required.

Skills

STD experience

Written comms

Verbal comms

AI-assisted tasks

Education

High School Diploma

Bachelor's degree

Tools

AI tools

Job description

MetLife’s Global Customer Service and Operations team seeks to improve customer care through trust and empathy while delivering efficient disability claim processing. The role focuses on timely STD/LTD claim decisions, using AI to enhance speed and accuracy, and collaborating with clinicians and attorneys across a hybrid work model.

You will work within a diverse GTO group focused on improving claims outcomes, serving customers and communities with professional, compliant communication and