Job Location: United States:Florida : Tampa
Role Value Proposition:
Evaluates individual disability income insurance claims and exercises independent judgment, discretion and critical analysis to reach reasonable claims determinations that are in accordance with contract provisions and time service standards.
- Manages assigned caseload with limited supervision.
- Provides timely, balanced and accurate claims reviews, documentation and recommended decisions in a time sensitive and fast-paced environment.
- Compiles file documentation and correspondence requiring extensive policy and factual detail.
- Identifies information and resources needed to adjudicate claim.
- Communicates decisions to policyholders in verbal and written form.
- Conducts lengthy detailed information-gathering phone calls that obtain medical condition details, financial details, occupational details and other information.
- Refers to external and internal resources, such as physicians, attorneys and CPAs to gather data such as medical/occupational information in order to ensure well-reasoned decisions.
- Clarifies and reconciles inconsistencies.
- Proficiently calculates benefits due after elimination period, COLA, Social Security Offsets, and residual and non-routine payments.
- Drafts responses to Department of Insurance and Presidential complaints. Identifies and refers appropriate matters to legal counsel.
- Represents MetLife at depositions and trials.
- Performs other related duties as assigned or required.
Essential Business Experience and Technical Skills:
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.
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Requisition #: 61882 Nearest Major Market:
Location/Region: Tampa, FL (US)