Description

Description and Requirements

An expert technical resource to the claim team who supports the 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. .

Key Responsibilities:

• Partners with the STD Unit Leader to analyze and Identify barriers for the success and efficiency of their team. Supports and guides assigned team member to ensure that they have the knowledge and skills, tools, and resources to be successful in achieving those expectations by 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 auditing claim file reviews to identify improvement opportunities, skillset gaps, trends for quality, service and/or compliance
• Accountable for Reviews and 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 a ppropriately investigates other income/offsets in accordance with Customer's plan/policy
• Managing operation efficiency goals and provides positive reinforcement to team members that is directly linked to their behaviors and performance objectives and maintains data integrity.
• Performs other related duties as assigned or required



Essential Business Experience and Technical Skills:

Required:


• A comprehensive understanding of the 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 with the goal of setting claimant expectations and obtaining information necessary to administer the claim.
• Basic knowledge of medical conditions, treatments, prognosis
• Critical-thinking skills
• 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.
• Ability to Partner with Internal/External Customers
• High School Diploma



Preferred:
• Associate Degree
• 2 plus years of claims management experience preferably in Healthcare field
• 5 plus years of Management
• Proficient in Microsoft Word/Excel



Key Competencies, Qualifications and Skills, Preferred:

• Prior STD, state leave and/or Family Medical Leave Act claims knowledge preferred.
• Strong communication skills, both written and oral.
• Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
• Strong problem solving and analytical skills.
• Ability to work independently
• Ability to multitask, comfortable working with multiple priorities in a changing environment.
• Ability to prioritize and maintain quality

The expected salary range for this position is $49,100 - $80,169. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.

Benefits We Offer

Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. 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!

About MetLife

Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces™, as well as the Fortune 100 Best Companies to Work For®, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our 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. At MetLife, it's #AllTogetherPossible . Join us!

MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").

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.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.

$49,100 - $80,169


Requisition #: 15652

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