STD Claims Specialist – AI-Enabled, Impactful Work

MetLife; Clarks Summit (Lackawanna County); Hybrid; USD 42,000 - 72,000; Full time

Benefits offered by this job

Health insurance

401(k) with employer matching

Life insurance

Disability insurance

Paid time off

Paid holidays

Job summary

MetLife seeks a detail-focused claims professional to process STD/LTD disability claims with accuracy and speed. You will analyze claim data, gather medical and vocational information, and decide on liability while complying with federal and state laws.

Regularly collaborate with medical professionals, claimants, and attorneys to reach timely outcomes. You will operate within a nationwide office network, with monthly in-person meetings and frequent use of AI tools to enhance speed, quality, and

Qualifications

• Must live within commutable distance of listed U.S. offices including Clark Summit, PA.
• In-office presence once a month for meetings.
• High School Diploma required.
• 2+ years of short-term disability (STD) experience.
• Disability insurance, written and verbal communication skills.
• Ability to use AI to improve speed, quality and efficiency.

Responsibilities

• Independently assess, analyze, and render claim decisions on STD, PML, and state claims.
• Clarify functional capacity with problem-solving and information gathering.
• Adhere to federal and state laws to maintain timely outcomes.
• Communicate clearly to influence return to work and explain payment basis.
• Gather information from claimants, doctors, nurses, employers, and attorneys.
• Document rationale for claim direction and act beyond CMG guidelines when justified.
• Use tools to identify work, prioritize, and involve resources as needed.
• Determine return-to-work potential and likely progression of claims.
• Perform other duties as required.

Skills

STD claims experience

Communication skills

AI in tasks

Education

High School Diploma

Bachelor's degree

Job description

MetLife seeks a detail-focused claims professional to process STD/LTD disability claims with accuracy and speed. You will analyze claim data, gather medical and vocational information, and decide on liability while complying with federal and state laws.

Regularly collaborate with medical professionals, claimants, and attorneys to reach timely outcomes. You will operate within a nationwide office network, with monthly in-person meetings and frequent use of AI tools to enhance speed, quality, and