Senior LTD SHU Reassessment Claims Specialist

MetLife, Inc.; United States; Teletrabalho; USD 58 000 - 69 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

401(k) with employer matching

Life insurance

Disability insurance

Paid time off

Resumo da oferta

MetLife is seeking a Senior LTD Claim Specialist to independently evaluate and manage moderately complex long-term disability claims within the U.S. Long-Term Disability organization.

You’ll apply independent judgment, provide exceptional customer service, and navigate the claims process with clarity and confidence. In this role you will review earnings, assess functionality, coordinate with fraud resources, and prepare accurate claim decisions and communications.

Qualificações

• High School Diploma required with 2+ years LTD/IDI insurance claims experience.
• Strong critical thinking, analysis and problem-solving abilities.
• Excellent communication, organization and time management skills.
• Customer-focused, collaborative professional delivering high-quality service.

Responsabilidades

• Lead independent evaluation and reassessment of a caseload of moderately complex long-term disability claims.
• Create timely, balanced claim reviews and recommended decisions.
• Oversee written communications describing evaluation status and determinations.
• Coordinate with fraud resources as needed and ensure adherence to regulations.
• Develop accurate monthly benefit calculations including post-elimination period components.

Conhecimentos

Critical thinking

Analysis

Problem-solving

Organization

Time management

Communication

Customer service

Formação académica

High School Diploma

LTD/IDI claims experience

Descrição da oferta de emprego

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.

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 Senior LTD Claim Specialist is responsible for independently evaluating and managing moderately complex long-term disability claims within MetLife’s U.S. Long-Term Disability 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 make a meaningful impact in the lives of our customers and communities. In this role, you will apply independent judgment, critical thinking, exemplary customer service and effective inventory management to deliver timely, balanced and accurate claim decisions while helping claimants navigate the claims process with clarity and confidence.

Key Responsibilities

• Lead the independent evaluation and reassessment of an assigned caseload of moderately complex ongoing long-term disability claims, including reviews for additional earnings, potential fraud activity, return-to-work capacity and changes in functionality.
• Create timely, balanced and accurate claim reviews, documentation and recommended decisions in a fast-paced environment and in accordance with state and department of insurance regulations. Oversee proactive verbal communication with claimants and their representatives, using empathy and active listening to explain the claim process, benefits and plan provisions and to gather essential medical, occupational and financial information.
• Manage the clarification and reconciliation of inconsistencies identified during claim evaluations, collaborating with Fraud, Waste and Abuse resources as needed.
• Develop accurate monthly benefit calculations following the elimination period, including cost-of-living adjustments, Social Security offsets, rehabilitation return-to-work benefits and other non-routine payments.
• Coordinate timely and detailed written claim communications and file documentation that clearly describe evaluation status, claim determinations and relevant claimant conversations.

Required Qualifications

• High School Diploma and 2+ years of LTD or IDI insurance claims experience, applied to independently evaluate complex claim information and make sound, fact-based decisions.
• Proficiency in managing multiple systems and technology resources to review claim information, document findings and support timely claim determinations.
• Strong critical thinking, analysis, creative problem-solving, conceptual thinking, risk management, organization and time management skills, with the ability to handle complex situations and competing priorities effectively.
• A customer-focused, collaborative and accountable professional who demonstrates excellent verbal and written communication, strong interpersonal skills, sound independent judgment and a commitment to delivering high-quality service.

Preferred Qualifications

• Knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security

The expected salary range for this position is $58,000 - $69,000 . 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.