Lead LTD Shu Reassessment Claims Specialist

MetLife; United States; À distance; USD 64 000 - 80 000; Plein temps

Avantages offerts par ce poste

Health plan

Life insurance

401(k) with employer matching

Paid time off

Résumé du poste

MetLife is seeking a Lead SHU Reassessment Claims Specialist to independently manage the most complex long‑term disability claims in the U.S. LTD group, offering technical expertise, coaching, and leadership support.

You will mentor associates, partner with leaders on quality and customer experience initiatives, and ensure timely, balanced claim outcomes while complying with regulations.

Qualifications

• 5+ years of LTD/IDI Insurance Claims experience.
• Excellent customer service skills demonstrated through interactions with customers and stakeholders.

Responsabilités

• Independently manage the most complex claims within a fast‑paced environment, providing timely and accurate reviews and decisions.
• Calculate monthly benefits after the elimination period, including COLA, Social Security offsets, and Rehab Return to Work benefits.
• Collaborate with physicians, attorneys, and CPAs to gather data for thorough claim determinations.
• Clarify and resolve inconsistencies in information and refer matters to appeals or litigation support as needed.
• Support leadership with onboarding, coaching, and development, and provide feedback on team performance.

Connaissances

LTD/IDI Claims

Formation

Bachelor’s degree

Description du poste

On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement. Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide. Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time.

The Opportunity

The Lead SHU Reassessment Claims Specialist is responsible for independently managing the most complex long-term disability claims while providing technical expertise, coaching, and leadership support across the U.S. LTD organization. Guided by our purpose – always with you, building a more confident future – and our New Frontier strategy focused on stronger growth, attractive returns, and all-weather performance, this is an exciting opportunity to deliver timely, balanced claim outcomes that make a meaningful difference for customers. In this role, you will apply sound judgment and critical thinking, mentor and develop associates, and partner with leaders on initiatives that improve quality, customer experience, operational performance, and staff development.

Key Responsibilities

• Independently manage an assigned caseload of the most complex claims which consists of pending and ongoing/active reviews. 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.Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination and interacts and communicates effectively with claimants, customers, health care providers, 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. 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.
• Collaborates effectively with both external and internal resources, such as physicians, attorneys, vocational consultants and CPAs, 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 and addresses/resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areas.
• Serves as an extended leadership team member, participates in new hire onboarding including coaching, mentoring and development, providing direct support to Unit Leaders, and partners with the leadership team to meet project goals related to quality, timely claim outcomes, customer service and staff development and provide detailed, balanced feedback to leadership on individual, team, customer or site performance and offers solutions on opportunities identified.

Required Qualifications

• 5+ years of LTD/IDI Insurance Claims experience with excellent customer service skills proven through internal and external customer interactions and prior experience with independent judgement and decision making while relying on the available facts/problem solving/critical thinking while having the ability to effectively manage multiple systems and technology resources/Organizational and time management skills.

Preferred Qualifications

• Bachelor’s degree and knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security.

The expected salary range for this position is $64,000 - $80,000. 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 click here .

About MetLife

Recognizedon Fortune magazine's list of the \"World's Most Admired Companies\",Fortune World’s 25 Best Workplaces™, as well as the Fortune 100 Best Companiesto Work For®, MetLife, through its subsidiaries and affiliates, is one of theworld’s leading financial services companies; providing insurance, annuities,employee benefits and asset management to individual and institutionalcustomers. With operations in more than 40 markets, we hold leading positionsin 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 purposeis simple - to help our colleagues, customers, communities, and the world atlarge create a more confident future. United by purpose and guided by our corevalues - Win Together, Do the Right Thing, Deliver Impact Over Activity, andThink Ahead - we’re inspired to transform the next century in financialservices. 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 90 days from the listed posting date.