Individual Disability Claims Specialist II
Location: Safety Harbor
Posted on: November 22, 2021
9/2/2021 9:02:59 PM Role Value Proposition:
At MetLife, we seek to make a meaningful impact in the lives of our
customers and our communities. The IDI Claims Specialist evaluates
individual disability income insurance claims and exercises
independent judgment, discretion and critical analysis to reach
reasonable claims determinations that are in accordance with
contract provisions and time service standards.
Effectively manages an assigned caseload with limited supervision
which consists of pending, ongoing and appeal reviews.
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.
Conducts lengthy detailed information-gathering telephone calls
with Insured 's or their representatives to obtain medical
condition details, financial details, occupational details and
other information pertinent to the evaluation of the claim. Once
telephone calls are completed, you will be required to document the
facts of the conversation within the claim file in a timely manner
utilizing appropriate level of detail and professional writing
Interacts and communicates effectively with Insureds, attorneys,
brokers, and family members during claim evaluation
Compiles file documentation and correspondence requiring extensive
policy and factual detail. - Analyzes information to determine if
additional proofs are needed to make a reasonable and logical
claims determination based off the information available.
Collaborates with both external and internal resources, such as
physicians, attorneys, vocational consultants and CPAs to gather
data such as medical/occupational information in order to ensure
Clarifies and reconciles inconsistencies when gathering information
during claim evaluations and represents MetLife at depositions and
trials. When needed, collaborates with underwriting department and
Fraud Waste and Abuse partners.
Proficiently calculates monthly benefits due after elimination
period, to include COLA, Social Security Offsets, and Residual
Disability and non-routine payments. - Documents claim files with
Prepares freeform letters to insureds and/or their representatives,
both during and after completion of claim evaluation, which
outlines and support the status of the evaluation and/or claim
determination. Frequently engages in conversations with our
insureds and/or their representatives, in which it is necessary to
demonstrate active listening and conduct information gathering to
be able to articulate the claims decision upon the completion of an
evaluation, as well as being able to explain pertinent policy
language in detail.
Addresses and resolves escalated customer complaints in a timely
and thorough manner. When required, drafts written responses to
Department of Insurance and Presidential complaints. Identifies and
refers appropriate matters to legal counsel.
Essential Business Experience and Technical Skills:
High school diploma
2 years of related professional business experience
Prior experience with independent judgement and decision making
while relying on the available facts.
Be able to demonstrate the use of critical thinking and analysis
when reviewing the information.
Creative problem-solving abilities when working in grey areas and
the ability to think outside the box.
Excellent interpersonal and communication skills in both verbal and
Professional freeform business writing skills using clear and
concise language and grammar.
Excellent customer service skills proven through internal and
external customer interactions with high level professional
Demonstrated conceptual thinking, risk management, ability to
handle complex situations effectively.
Organizational and time management skills.
Bachelor 's degree
3 to 5 years of related professional business experience
Individual Disability Income claims experience.
-At MetLife, we 're leading the global transformation of an
industry we 've long defined. United in purpose, diverse in
perspective, we 're dedicated to making a difference in the lives
of our customers. -
MetLife, through its subsidiaries and affiliates, is one of the
world 's leading financial services companies, providing insurance,
annuities, employee benefits and asset management to help its
individual and institutional customers navigate their changing
world. Founded in 1868, MetLife has operations in more than 40
countries and holds leading market positions in the United States,
Japan, Latin America, Asia, Europe and the Middle East.
We are one of the largest institutional investors in the U.S. with
$659.6 -billion of total assets under management as of December 31,
-2020. We are ranked #48 on the Fortune 500 list for 2020. In 2020,
-we were named to the Dow Jones Sustainability Index (DJSI) for the
fifth year in a row. DJSI is a global index to track the leading
MetLife is committed to building a purpose-driven and inclusive
culture that energizes our people. Our employees work every day to
help build a more confident future for people around the world. -
Visit us at www.metlife.com to learn more about our brand, history,
We want to make it simple for all interested and qualified
candidates to apply for employment opportunities with MetLife. - If
you need assistance and/or a reasonable accommodation due to a
disability during the application or the recruiting process, please
send a request -to email@example.com or call our Employee
Relations Department at 1-877-843-3711.
MetLife is a proud Equal Employment Opportunity and Affirmative
Action employer dedicated to attracting, retaining, and developing
a diverse and inclusive workforce. All qualified applicants will
receive consideration for employment at MetLife without regards to
race, color, religion, sex (including pregnancy, childbirth, or
related medical conditions), sexual orientation, gender identity or
expression, age, disability, national origin, marital or
domestic/civil partnership status, genetic information, citizenship
status, uniformed service member or veteran status, or any other
characteristic protected by law.
MetLife maintains a drug-free workplace.
Requisition #: 117398
Keywords: MetLife, Clearwater , Individual Disability Claims Specialist II, Other , Safety Harbor, Florida
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