STD Claim Support Specialist

About the Role

An expert technical resource to the claim team who supports team members and the STD Unit Leader in ensuring claim management accuracy, customer centricity, and efficiency. Coaches and mentors team members to enhance their knowledge, skills, and effectiveness as claim-management professionals.

Responsibilities

• Partners with the STD Unit Leader to analyze and identify barriers to team success and efficiency.
• Supports and guides assigned team members to ensure they have the knowledge, skills, tools, and resources to succeed, including delivering on commitments, timely return of phone calls, clear communication, accuracy of decisions, and financial accuracy.
• Drives claim management accuracy and customer centricity through support of the Pre-QA Program, claim file reviews, and call monitoring; audits claim file reviews to identify improvement opportunities, skillset gaps, trends for quality, service, and/or compliance.
• Reviews and approves key decisions made by team members within authority limits, including financial accuracy of coding claims systems, accurate claim benefit amount/salary, and appropriate investigation of other income/offsets in accordance with the customer’s plan/policy.
• Manages operational efficiency goals and provides positive reinforcement to team members linked to their behaviors and performance objectives while maintaining data integrity.
• Performs other related duties as assigned or required.

Requirements

• A comprehensive understanding of disability contractual provisions, especially the definition of disability.
• Ability to coach and mentor members of the team.
• Strong communication skills, including the ability to interview claimants dynamically to set expectations and obtain necessary information to administer claims.
• Basic knowledge of medical conditions, treatments, and prognosis.
• Critical-thinking and strategic-thinking skills, with the ability to apply judgment and decision-making based on strategy.
• Prioritization skills and the ability to balance quantity and quality.
• Ability to partner with internal/external customers.
• High school diploma.

Preferred Qualifications

• Associate degree.
• 2+ years of claims management experience, preferably in the healthcare field.
• 5+ years of management experience.
• Proficiency in Microsoft Word/Excel.
• Prior STD, state leave, and/or Family Medical Leave Act claims knowledge.
• Strong written and oral communication skills.
• Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
• Strong problem-solving and analytical skills.
• Ability to work independently and multitask in a changing environment.

Pay

The expected salary range for this position is $49,100 - $82,800. 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

• Comprehensive health plan including medical/prescription drug, vision, and dental insurance.
• No-cost short- and long-term disability.
• Company-paid life insurance and legal services.
• Retirement pension funded entirely by MetLife and 401(k) with employer matching.
• Group discounts on voluntary insurance products (auto, home, pet, critical illness, hospital indemnity, and accident insurance).
• Employee Assistance Program (EAP) and digital mental health programs.
• Parental leave, paid time off, paid holidays, and volunteer time off.
• Tuition assistance.

About MetLife

Recognized on Fortune magazine’s list of the "World's Most Admired Companies," Fortune World’s 25 Best Workplaces™, and the Fortune 100 Best Companies to Work For®, MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies. With operations in more than 40 markets, MetLife holds leading positions in the United States, Latin America, Asia, Europe, and the Middle East. Our purpose is to help colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by core values—Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead—we’re inspired to transform the next century in financial services.