Short Term Disability Claim Specialist

Job Location : Virtual (AFTER TRAINING - TRAINING IS IN PERSON FOR A MINIMUM OF 7 WEEKS), but must be in a commutable distance from any of the following offices : Bloomfield, CTTampa, FLCandidates will be required to come into the office ONCE A MONTH after training.Role Overview : Claim owner and decision-maker. Responsible for administering claims within contractual provisions and internal / external guidelines. Establishes a relationship with claimants in order to understand their perspective on their disability. Using that perspective and other information, identifies the claimant’s functional capacity and leverages that capacity within the context of the contract to support and encourages return to work as appropriate.Key Responsibilities : Manages overall STD block of claims and possible companion claims to include Statutory plans, Federal, Company, State and other Leave types as required by our group customers or other Federal, State, Local lawsCreates and executes individual claim action plans, serves as point of contact for the claimant and provides a high-level of service to the claimant, including delivering on commitments, timely return of phone calls, and clear communication, and makes claim decisions. Proactively communicates / updates to partners that may be working with the claimant when key events are being considered or have occurred (Closure, RTW, etc.)Proactively communicates with the claimant to set expectations, assess medical and non-medical barriers to return to work, and keep him or her fully aware of the status of the claim, including setting expectations with the claimant if other resources (Voc, etc.) will be contacting him / her. Partners with the claimant, specialty resources, and more experienced resources to ensure that each claim has a well-understood plan that is appropriate for the unique situation of each claimant, his or her functional capacity and the prognosis for an increase in that capacity.Meet and Exceed Operational Efficiency goals, Demonstrate Service Delivery and Customer Satisfaction goals, including prioritizing actions, appropriately utilizing resources timely, maintain data integrity through accurate benefit decision and paymentAccountable for accurate financial decisions on block of claims with financial base benefit amount up to $8000 per week per claim decisions made in accordance with Customer provisionsApplies all appropriate provisions of the disability contract to ensure that MetLife’s liability is understood and appropriately applied throughout the life of the claim. Within the context of liability, encourage and support return to work through a variety of programs and methodologies.Performs all other duties as required.Essential Business Experience and Key Behaviors, Required : Understands value in building rapport and develops positive working relationshipsMotivated by their interactions with othersQuickly grasps information and efficiently solves verbal challenges with strategic thinkingCommunicates complex verbal and written concepts with easePays close attention to details, and accounts for details that may be overlookedProfessionally demonstrate empathy to othersProvide original insights on familiar subjectsBalances task work while adapting to change and exploring new innovative ideasAbility to prioritize and maintain qualityHigh School DiplomaKey Competencies, Qualifications and Skills, Preferred : Associate Degree or higher2 plus years of claims management experience preferably in Healthcare fieldProficient with Microsoft office softwarePrior STD and Family Medical Leave Act claims knowledgeAbility to work independentlyA comprehensive understanding of the disability contractual provisions, especially the definition of disability.Strong communication skills, including the ability to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim.Ability to give and receive feedback to / from partnersBasic knowledge of medical conditions, treatments, prognosisCritical-thinking skills, strategic-thinking skills and the ability to apply judgment and decision-making based on strategyPrioritization skills. Ability to balance quantity and quality.Equal Employment Opportunity / Disability / VeteransIf 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.

Salary : $8,000