[Remote] Long Term Disability Claims Specialist II

Note: The job is a remote job and is open to candidates in USA. MetLife is a leading financial services company dedicated to making a meaningful impact in the lives of customers and communities. The LTD Claims Specialist II evaluates long term disability insurance claims, exercising independent judgment and critical thinking while ensuring exemplary customer service and effective inventory management.ResponsibilitiesVirtual roles predominately work from a home office with periodic visits to the assigned office as needed for team events, meetings, training, business continuity, etcEffectively manages with minimal oversight an assigned caseload of moderately complex claims 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 their decision-making and demonstrate consistency in meeting all key performance indicatorsProvides 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 regulationsDevelop actions plans and identify return to work potentialProvides frequent, proactive verbal communication with our 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. These calls are used to gather essential details regarding medical condition(s) and treatment, occupational demands, financial information and any other information that may be pertinent to the evaluation of the claim. Once telephone calls are completed, you will be required to document the conversation within the claim file in a timely manner utilizing the appropriate level of detail and professional writing skillsInteracts and communicates effectively with claimants, customers, attorneys, brokers, and family members during claim evaluationsCompiles 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 off the information availableCollaborates 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 decisionsClarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as neededProficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, and Rehab Return to Work benefits, and other non-routine paymentsProvides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determinationAddresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint, or litigation support areasSkillsHigh school diplomaPrior experience with independent judgement and decision making while relying on the available factsBe able to demonstrate the use of critical thinking and analysis when reviewing the informationCreative problem-solving abilities and the ability to think outside the boxExcellent interpersonal and communication skills in both verbal and written formExcellent customer service skills proven through internal and external customer interactionsDemonstrated conceptual thinking, risk management, ability to handle complex situations effectivelyOrganizational and time management skillsMinimum 1 year LTD/IDI Insurance Claims experienceBachelor's degreeBenefitsComprehensive health plan that includes medical/prescription drug and visionDental insuranceNo-cost short- and long-term disabilityCompany-paid life insuranceLegal servicesA retirement pension funded entirely by MetLife401(k) with employer matchingGroup discounts on voluntary insurance products including auto and homePetCritical illnessHospital indemnityAccident insuranceEmployee Assistance Program (EAP)Digital mental health programsParental leaveVolunteer time offTuition assistanceCompany OverviewMetLife is a provider of insurance, employee benefits, and financial services . It was founded in 1868, and is headquartered in New York, New York, USA, with a workforce of 10001+ employees. Its website is http://www.metlife.com.Company H1B SponsorshipMetLife has a track record of offering H1B sponsorships, with 164 in 2025, 108 in 2024, 113 in 2023, 155 in 2022, 75 in 2021, 81 in 2020. Please note that this does not guarantee sponsorship for this specific role.



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