17 days old

Lead LTD Claims Specialist

Marlborough, MA
**Job Location:** Marlborough, MA

**Role Value Proposition:**

Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. Were looking for unique talent with fresh perspectives that can propel innovation. In this role you will handle the most complex claims and be a leader and mentor within their site for claim management. This role will work with new hires as a coach to help them maximize their abilities related to claim decision making and service delivery. The Lead Claims Specialist will be a technical expert and an emerging leader who will be a change agent and will be asked to participate on various continuous improvement projects to provide input on new ideas or designs influencing how we manage claims and service customers. The Lead Claims Specialist is the highest level individual contributor resource that manages claims within the LTD organization

**Key Responsibilities:**

+ Makes independent decisions in managing assigned caseload (up to 85) depending on the complexity of claims and business needs.

+ Assists UL with workload balancing and work prioritization.

+ Independently assess, analyze and render appropriate claim decisions, consistent with the applicable plans and federal and state law, to maintain appropriate and timely claim outcomes.

+ Possesses and exercise the autonomy to take steps outside of CMG guidelines when supported by documented rationale and the facts of the claim file.

+ Articulates and documents their rationale for claim direction.

+ Acts as individual, team and office resource for claim related and technical issues.

+ Participates in new hire onboarding as well as one on one coaching, mentoring and development.

+ Serves as an extended leadership team member, providing direct support to Unit Leaders, and partners with leadership team to meet project goals related to quality, timeliness, and customer service and staff development.

+ Reviews claim blocks, reports and data to track and analyze information against established claims metrics on standard and customized levels. Identifies best practices and opportunities. Works with leadership team to increase individual, team and organizational capabilities.

+ Proactively mitigates risk by identifying trends within claim blocks, and offering feedback and solutions to improve overall performance.

+ Provides feedback to leadership team on individual, team, customer or site performance. Responsible for identifying internal and external industry trends and International Claim Association (ICA) site lead.

+ Partner with cross functional areas (LIFT, Account Team etc.) to provide subject matter expertise in the following areas: Overall Claims Management, Technical Skills, Communication, Work Prioritization, CDM Execution, and Return to Work focus.

+ Performs other related duties as assigned or required.

**Essential Business Experience and Technical Skills:**


+ High School Diploma; 10+ years of STD/LTD/IDI claims experience

+ Knowledge of data collection, analysis and reporting techniques


+ May require specialized knowledge acquired through formal claim training

+ Bachelors Degree preferred

**Salary Grade**




**Business Category**

_Global Technology and Operations_

**Number of Openings**


**At MetLife, were leading the global transformation of an industry weve long defined. United in purpose, diverse in perspective, were dedicated to making a difference in the lives of our customers.**

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.

**For immediate consideration, click the Apply Now button. You will be directed to complete an on-line profile. Upon completion, you will receive an automated confirmation email verifying you have successfully applied to the job.**

Requisition #: 95637


  • Customer Service

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Lead LTD Claims Specialist

Marlborough, MA

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