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[Remote] Disability Bridge Lead Claims 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, and they are seeking a Disability Bridge Lead Claims Specialist. This role is responsible for providing technical assistance and coaching to disability claims professionals, ensuring that key performance indicators are met and managing complex disability claim adjudication.
Responsibilities
- Lead complex disability claim adjudication across the STD‑to‑LTD transition by applying contractual provisions, regulatory requirements, and sound judgment to ensure accurate liability decisions while supporting appropriate return‑to‑work outcomes
- Create clear, thorough claim documentation, correspondence, and action plans that synthesize medical, vocational, and non‑medical information to support well‑reasoned, compliant, and defensible claim determinations
- Oversee high‑quality, timely claim reviews and evaluations in a fast‑paced environment, ensuring alignment with plan provisions, state and Department of Insurance regulations, and MetLife quality and customer service standards
- Manage the most complex assigned caseload independently, delivering consistent results through effective prioritization, proactive claimant engagement, and accountability for end‑to‑end claim outcomes in a virtual work environment
- Develop return‑to‑work opportunities by assessing functional capacity, medical and non‑medical barriers, and prognosis, building individualized strategies that leverage claimant capabilities within the terms of the disability contract
- Coordinate across internal and external partners—including claimants, physicians, attorneys, clinical and vocational consultants, Fraud, Waste and Abuse resources, Unit Leaders, and leadership teams—to clarify inconsistencies, support investigations, mentor new hires, and contribute to team performance, quality improvement, and talent development initiatives
Skills
- 5+ years of STD/LTD Insurance Claims experience with excellent customer service skills proven through internal and external customer interactions and prior experience with independent judgement and decision making while relying on the available facts/problem solving/critical thinking while having the ability to effectively manage multiple systems and technology resources/Organizational and time management skills
- Excellent interpersonal and communication skills in both verbal and written form
- Excellent customer service skills proven through internal and external customer interactions
- College or University degree
- Call center experience in an insurance setting
- Ability to give and receive feedback to/from partners
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
- Paid time off
- Paid holidays
- Volunteer time off
- Tuition assistance
Company Overview
