MetLife · 21 hours ago
Senior IDI Claims Specialist
United States
Full-time
Remote
Mid, Senior Level
$70K/yr - $85K/yr
2+ years expMetLife is a leading financial services company recognized for its commitment to making a meaningful impact in the lives of customers and communities. The IDI Senior Claims Specialist evaluates individual disability income insurance claims, exercises independent judgment, and provides exemplary customer service while managing a caseload of claims.
Asset ManagementFinancial ServicesInsuranceLife InsuranceRisk Management
Responsibilities
Effectively and independently manages an assigned caseload of, and make claims decisions on, moderately complex claims which consists of pending, ongoing, and appeal reviews
Provides timely, balanced, and accurate claims reviews, documentation, and decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations
Serve as the face of the company in providing frequent, proactive verbal communication with our claimants, customers and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits, and other pertinent policy 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 Claims Specialist’s 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 skills
Interacts and communicates effectively with claimants, customers, health care providers, attorneys, brokers, and family members during the Claim Specialist’s claim evaluation
Compiles file documentation and correspondence requiring extensive policy analysis and factual detail. Analyzes information to determine if additional information is 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 to ensure the Claims Specialists claim decisions are well-reasoned and thorough
Identifies, clarifies, and reconciles inconsistencies when gathering information during claim evaluations and collaborates with underwriting and Fraud Waste and Abuse resources as needed
Identifies offsets and proficiently calculates monthly benefits due after elimination period, to include COLA, Social Security Offsets, Residual Disability, and non-routine payments
Provides timely and detailed written communication during the claim evaluation, which outlines and support the status of the evaluation and/or claim determination
Addresses and resolves escalated customer complaints in a timely and thorough manner, including drafting written responses to Department of Insurance and Presidential complaints. Identifies and refers appropriate matters to litigation support partners
May represent MetLife at depositions and trials
Qualification
Required
Prior experience with independent judgement and decision making
Critical thinking and analysis skills when reviewing 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 written form
Excellent customer service skills proven through internal and external customer interactions
Demonstrated conceptual thinking, risk management, ability to handle complex situations effectively
Organizational and time management skills
Ability to effectively manage multiple systems and technology sources
2+ years of IDI or LTD insurance claims experience
Preferred
Bachelor's degree
Benefits
Comprehensive health plan that includes medical/prescription drug and vision
Dental insurance
No-cost short- and long-term disability
Company-paid life insurance
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
Accident insurance
Employee Assistance Program (EAP)
Digital mental health programs
Parental leave
Volunteer time off
Tuition assistance
Company
MetLife
MetLife is a provider of insurance, employee benefits, and financial services .
10001+ employees
H1B Sponsorship
MetLife has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (164)
2024 (108)
2023 (113)
2022 (155)
2021 (75)
2020 (81)
Funding
Current Stage
Public CompanyTotal Funding
$500M2024-06-20Post Ipo Debt· $500M
2000-04-14IPO
Leadership Team
Michel A. Khalaf
President & CEO, MetLife, Inc.
Koley Corte
Senior Vice President & Chief Marketing Officer - Institutional, Regional, Global Insights+Analytics
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