Easter Seals Jobs

Job Location - Virtual - Tampa FL, Bloomfield CT, Aurora IL, Cary NC, Oriskany NY (Central NY), Bridgewater, NJ, Clarks Summit, PA, Omaha, NE, Warwick, RI

We work closely with our partners in both the financial and overpayment units to ensure final benefits, and any potential survivor benefits, are paid accurately to the appropriate party, ensuring that any outstanding overpayment is recovered prior to release of funds. We are, in most cases, the final contact the family of an LTD claimant has with MetLife Disability.

This position will require frequent phone conversations with the families of deceased claimants at a time when the families may be very uncertain about next steps, the provisions of the LTD Plan, how much (if any) benefit is due and who is an eligible to receive the money now that the claimant is deceased. Empathetic listening skills are necessary as is excellent customer service.

The person who fills this position must be willing to adapt and open to change.

Key Responsibilities: 

•Effectively and independently manages an assigned caseload of death claims.

•Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment and in accordance with state and department of insurance regulations.

• Provides frequent, proactive verbal communication with our claimants and/or their representatives demonstrating empathy and active listening while providing clear updates, direction and explanations regarding the claim process, benefits and other pertinent plan provisions. 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 customers, health care providers, attorneys, brokers, and family members during claim evaluations.

•Compiles file documentation and correspondence requiring extensive policy 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 effectively with both external and internal resources, such as physicians, attorneys, clinical and vocational consultants, as needed, to gather data in order to ensure reasonable, thorough decision.

•Clarifies and reconciles inconsistencies when gathering information during claim evaluations and collaborates with Fraud Waste and Abuse resources as needed.

•Proficiently calculates death and survivor benefits due.

•Provides timely and detailed written communication during the claim evaluation process which outlines the status of the evaluation and/or claim determination

•Addresses and resolves escalated customer complaints in a timely and thorough manner. Identifies and refers appropriate matters to our appeals, complaint or litigation support areas 

Essential Business Experience and Technical Skills:

Required:

•Prior experience with independent judgement and decision making while relying on the available facts

•Be able to demonstrate the use of critical thinking and analysis when reviewing the information

•Creative problem-solving abilities 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 resources

•3+ years of LTD or IDI Insurance Claims experience

Preferred:

•Bachelor’s degree

• Knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security

Equal Employment Opportunity/Disability/Veterans

If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.

MetLife maintains a drug-free workplace.