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[Remote] STD Claim Support Specialist
Note: The job is a remote job and is open to candidates in USA. MetLife is one of the world’s leading financial services companies, providing insurance and asset management to individual and institutional customers. The STD Claim Support Specialist serves as a technical resource for the claim team, focusing on enhancing claim management accuracy and customer service while mentoring team members for professional growth.
Responsibilities
- Partners with the STD Unit Leader to analyze, identify and implement strategies to enhance claim management, customer centricity and efficiency of their team while monitoring strategy effectiveness
- Drives Claim Management Accuracy and Customer Centricity through the QQA program by auditing claim file reviews including monthly call monitoring for Claims Specialist to identify improvement opportunities, skillset gaps, trends for quality, service and/or compliance
- Fully engages in customer focused training; model learned behaviors
- Supports and guides assigned team member(s) to ensure that they have the knowledge, skills, tools, and resources to be successful in achieving expectations
- Supports team to meet or exceed regulatory and compliance requirements, and performance guarantee commitments
- Coaches and mentors new hires to enhance their skills, knowledge, and effectiveness as Claim Specialists. Assesses new hire readiness or independent work
- Reviews and approves key decisions made by team member(s) within authority limit
- Assesses and provides information, trends, and observed behaviors of assigned team members to the STD Unit Leader. Partners with the STD Unit Leader as appropriate to enhance the performance of those team members
- Identifies and facilitates claim discussions on highly complex claims with the appropriate resources including STD Unit Leader, Clinical Resources and Vocational Rehabilitation Consultants
- Supports team members to ensure that team members are effectively transitioning claims to LTD (as appropriate)
- Mentors team members to ensure they are identifying and facilitating Return to Work opportunities through their own efforts or by engaging the appropriate resources
- Provides candid and specific feedback to team members in order to support their growth and development
Skills
- 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
- Partners with the STD Unit Leader to analyze, identify and implement strategies to enhance claim management, customer centricity and efficiency of their team while monitoring strategy effectiveness
- Drives Claim Management Accuracy and Customer Centricity through the QQA program by auditing claim file reviews including monthly call monitoring for Claims Specialist to identify improvement opportunities, skillset gaps, trends for quality, service and/or compliance
- Fully engages in customer focused training; model learned behaviors
- Supports and guides assigned team member(s) to ensure that they have the knowledge, skills, tools, and resources to be successful in achieving expectations
- Supports team to meet or exceed regulatory and compliance requirements, and performance guarantee commitments
- Coaches and mentors new hires to enhance their skills, knowledge, and effectiveness as Claim Specialists
- Assesses new hire readiness or independent work
- Reviews and approves key decisions made by team member(s) within authority limit
- Assesses and provides information, trends, and observed behaviors of assigned team members to the STD Unit Leader
- Partners with the STD Unit Leader as appropriate to enhance the performance of those team members
- Identifies and facilitates claim discussions on highly complex claims with the appropriate resources including STD Unit Leader, Clinical Resources and Vocational Rehabilitation Consultants
- Supports team members to ensure that team members are effectively transitioning claims to LTD (as appropriate)
- Mentors team members to ensure they are identifying and facilitating Return to Work opportunities through their own efforts or by engaging the appropriate resources
- Provides candid and specific feedback to team members in order to support their growth and development
- A comprehensive understanding of the disability contractual provisions, especially the definition of disability
- Strong communication skills, including the ability to coach Case Specialist 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
- Expertise knowledge of system and tools, ie …MDG, DPA, Intellis and how to leverage tools to improve claim management effectiveness
- Strong Coaching/Mentoring skills
- Critical-thinking skills
- Ability to give and receive feedback using specific measurements and observed behaviors
- Openness to receiving feedback
- Strategic-thinking skills
- Prioritization skills. Ability to balance quantity and quality
Benefits
- Comprehensive health plan that includes medical/prescription drug and vision
- Dental insurance
- No-cost short- and long-term disability
- Company-paid life insurance
- Legal services
- A retirement pension funded entirely by MetLife
- 401(k) with employer matching
- Group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance
- Employee Assistance Program (EAP)
- Digital mental health programs
- Parental leave
- Volunteer time off
- Tuition assistance
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