Note: The job is a remote job and is open to candidates in USA. MetLife is one of the world’s leading financial services companies, providing insurance and employee benefits. The Long Term Disability Claims Specialist is responsible for delivering accurate and empathetic evaluations of disability claims while ensuring compliance with regulations and supporting customer satisfaction.
Responsibilities
- Lead the evaluation of a caseload of moderately complex Long Term Disability claims, applying independent judgment while meeting productivity, quality, and compliance standards
- Create thorough, accurate claim documentation and written communications that clearly outline claim status, rationale, and determinations
- Oversee timely and compliant claim reviews in accordance with state regulations, Department of Insurance standards, and policy provisions
- Manage proactive, empathetic communication with claimants, attorneys, brokers, medical providers, employers, and family members throughout the claim lifecycle
- Develop action plans that identify return‑to‑work potential and appropriate rehabilitation opportunities
- Coordinate with internal and external resources, including physicians, vocational consultants, clinical teams, legal partners, and Fraud, Waste & Abuse resources to gather and reconcile medical, occupational, and financial information
Skills
- 1+ year of experience in Long Term Disability claims or disability claim management
- High school diploma with demonstrated ability to apply independent judgment and decision‑making to moderately complex claim evaluations
- Claims management systems and benefit calculation tools, used to evaluate LTD claims and accurately calculate benefits including COLA, Social Security offsets, and rehabilitation/return‑to‑work payments
- Strong critical thinking, analytical, and problem‑solving skills with the ability to interpret medical, occupational, and financial information
- Excellent communication and customer service skills, demonstrating empathy, professionalism, and clarity in both written and verbal interactions
- Experience collaborating with clinical, vocational, legal, or fraud prevention partners to support sound and defensible claim decisions
- Strong organizational and time‑management skills with the ability to prioritize effectively in a fast‑paced, virtual environment
- Demonstrated resilience and adaptability, with the ability to manage complex situations and escalated customer concerns professionally
Benefits
- Comprehensive health plan that includes medical/prescription drug and vision
- Dental insurance
- No-cost short- and long-term disability
- Company-paid life insurance and legal services
- A retirement pension funded entirely by MetLife
- 401(k) with employer matching
- Group discounts on voluntary insurance products including auto and home
- Pet
- Critical illness
- Hospital indemnity
- And accident insurance
- Employee Assistance Program (EAP)
- Digital mental health programs
- Parental leave
- Paid time off
- Paid holidays
- Volunteer time off
- Tuition assistance
Company Overview
MetLife 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.