Job Description

Long Term Disability Claims Specialist I Role Summary: At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The LTD Claims Specialist I evaluates long term disability insurance claims in accordance with plan provisions and within prescribed time service standards. In this role, the LTD Claims Specialist is required to exercise critical thinking skills, exemplary customer service skills, and effective inventory management skills with oversight and expected progression to a LTD Claims Specialist II role. Job Location: Virtual, but must be commutable to the Aurora, IL office. Employees are required to come into the office for 2 weeks after initial training. After training, employees are to report to the office 1× a month. Key Responsibilities: Virtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etc. Effectively manages some level of oversight of an assigned caseload which consists of pending, ongoing/active reviews. The LTD CS will be evaluated for increases in their authority levels as they become more experienced in decision‑making and demonstrate consistency in meeting all key performance indicators. 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. Develops action plans and identifies return‑to‑work potential. Provides frequent, proactive verbal communication with claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. Interacts and communicates effectively with claimants, customers, 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 on available information. Collaborates with both external and internal resources, such as physicians, attorneys, clinical/vocational consultants 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. Addresses and resolves escalated customer complaints in a timely and thorough manner; identifies and refers appropriate matters to appeals, complaint, or litigation support areas. Essential Business Experience and Technical Skills: Required: New hires should live a commutable distance from the site the role is posted in. High School Diploma. Minimum 2 years of experience in external customer service or related experience. Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning. Creative problem‑solving abilities and the ability to think outside the box. Excellent interpersonal and communication skills in both verbal and written form. Excellent customer service skills proven through internal and external customer interactions. Organizational and time‑management skills. Preferred: Bachelor’s degree. Business Category: Operations – Claims Salary Range: $41,600 – $53,800. 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, volunteer time off, tuition assistance and much more! MetLife is an Equal Opportunity Employer. All employment decisions are made without regard 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 accommodations@metlife.com. 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. #J-18808-Ljbffr MetLife Investment Management

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