Senior Long-Term Disability Claims Strategist

MetLife; United States; Vor Ort; USD 58.000 - 69.000; Vollzeit

Zusammenfassung

MetLife is seeking a Senior LTD Claims Specialist to evaluate long term disability claims across the United States, delivering timely, accurate determinations and compassionate customer support within plan provisions and regulatory requirements.

You will apply independent judgment, analyze medical and occupational information, coordinate with clinicians, attorneys, and partners, and manage a moderately complex caseload from initial review through appeals, contributing to quality, risk

Qualifikationen

• 3+ years of LTD Insurance Claims experience.
• Creative problem-solving abilities and the ability to think outside the box with independent judgement and decision making while relying on the available facts with the use of critical thinking and analysis when reviewing the information.
• Experience utilizing AI in a professional setting.

Aufgaben

• Lead timely, and accurate LTD claim evaluations and decisions in accordance with plan provisions,
• Create thorough claim documentation and correspondence by analyzing medical, occupational, financial, and policy information to support well‑documented determinations.
• Oversee claim evaluations by identifying and reconciling inconsistencies, leveraging Fraud, Waste and Abuse resources, and resolving escalated customer concerns while referring matters to appeals, complaints, or litigation support as needed.
• Manage communication with claimants, customers, providers, attorneys, brokers, and family members by delivering clear, timely updates on claim status, determinations, and complex benefit calculations.
• Coordinate with internal and external partners, including physicians, attorneys, vocational consultants, and CPAs, to obtain and evaluate information required for thorough and defensible claim decisions.

Kenntnisse

LTD claims experience

Independent judgment

Analytical thinking

Excellent communication

AI experience

Ausbildung

Bachelor’s degree

Jobbeschreibung

MetLife is seeking a Senior LTD Claims Specialist to evaluate long term disability claims across the United States, delivering timely, accurate determinations and compassionate customer support within plan provisions and regulatory requirements.

You will apply independent judgment, analyze medical and occupational information, coordinate with clinicians, attorneys, and partners, and manage a moderately complex caseload from initial review through appeals, contributing to quality, risk