Short Term Disability Claims SpecialistTampa, Florida
Job Location: Tampa, FL Alternate Location : None
Role Value Proposition:
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.
- Manages overall block of assigned claims in accordance to 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 payment
- 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 updates partners that may be working with the claimant when key events are being considered or have occurred. (Closure, RTW, etc.)
- Accountable approves key decisions made by team member(s) within authority limit including Financial accuracy of coding Claims System including accurate claim Benefit Amount/Salary and appropriately investigates other income/offsets in accordance with Customer’s plan/policy
- Actively demonstrate key behaviors - Active and engaged participant in regularly scheduled 1:1s and daily team huddles, Promotes and participate in a work environment including successfully working with others to achieve desired results; contributes to team goals, projects; exchanges ideas, opinions, develops positive working relationships.
- Performs other related duties as assigned or required
Essential Business Experience and Technical Skills:
- A 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.
- Basic knowledge of medical conditions, treatments, prognosis
- Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
- Ability to give and receive feedback to/from partners
- Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy
- Prioritization skills. Ability to balance quantity and quality.
- High School Diploma
- Associate Degree
- 2 plus years of claims management experience preferably in Healthcare field
- Proficient in Microsoft Word/Excel
Number of Openings
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MetLife is a proud equal opportunity/affirmative action employer committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. It is MetLife's policy to ensure equal employment opportunity without discrimination or harassment based on 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.
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Requisition # 112687