Short Term Disability Claims Specialist

About the role

The Hybrid STD / PFL Claims Specialist plays a vital role in supporting accurate claim outcomes, timely decisions, and a positive claimant experience across the United States. This role is part of MetLife’s Global Customer Service and Operations (GCSO) team, which is dedicated to delivering a differentiated experience grounded in operational excellence.

Responsibilities

• Lead the end-to-end review, analysis, and adjudication of Short-Term Disability (STD), Paid Family Leave (PFL/PFML), FMLA, ADA accommodations, and employer-specific leave claims in alignment with contract provisions, regulatory requirements, and company policies.
• Create clear, accurate, and timely claim communications that set expectations, provide status updates, explain decisions, and support a positive claimant and employer experience.
• Oversee claim activity from intake through closure by monitoring eligibility, applicability, liability, documentation, required information, and adherence to plan provisions.
• Manage an assigned caseload by prioritizing tasks, making timely and accurate decisions, maintaining confidentiality, meeting compliance requirements, and achieving quality, productivity, and KPI expectations.
• Develop individualized claim action plans, including return-to-work strategies, by assessing medical and non-medical barriers, claimant functional capacity, and available specialty resources.
• Cook up with claimants, employees, employers, specialty resources, and internal stakeholders to obtain information, resolve claim issues, support appropriate outcomes, and enhance the overall claimant experience.

Requirements

• A high school diploma or equivalent required to support accurate review, analysis, and adjudication of Short-Term Disability (STD), Paid Family Leave (PFL/PFML), FMLA, ADA accommodations, and employer-specific leave claims.
• Proficiency in Microsoft Office, including Word and Excel, to document claim activity, manage communications, track information, and support timely claim decisions.
• Strong written and verbal communication, critical thinking, analytical, and decision-making skills with the ability to manage multiple priorities in a fast-paced, customer-focused environment.
• Detail-oriented, accountable, and adaptable professional who demonstrates sound judgment, maintains confidentiality, and supports a positive claimant and employer experience.

Preferred Qualifications

• 1+ years of experience in disability claims, leave administration, or healthcare-related claims.
• Knowledge of STD contract provisions and federal/state leave laws (FMLA, ADA, PFML).
• An associate or bachelor’s degree.
• Experience managing a caseload and making independent claim decisions.

Pay

The expected salary range for this position is $40,000 - $52,000. This role may also be eligible for annual short-term incentive compensation and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms.

Benefits

We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, paid time off, paid holidays, volunteer time off, tuition assistance and much more!