Sr Long Term Disability Claims Specialist

Job description

Description and Requirements The Team You Will Join On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement. Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide.

Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time. The Opportunity The Senior Long-Term Disability (LTD) Claims Specialist is responsible for evaluating long term disability insurance claims—delivering timely, balanced, and accurate claim decisions and customer support in accordance with plan provisions, regulatory requirements, and prescribed service standards—across the United States.

Guided by our purpose – always with you building a more confident future – and our New Frontier strategy focused on stronger growth, attractive returns and all-weather performance, this is an exciting opportunity to manage a caseload of moderately complex LTD claims from initial review through ongoing management and appeals. You will apply independent judgment and critical thinking to analyze medical and occupational information, collaborate with internal and external partners (e.g., clinical and vocational consultants, physicians, attorneys), and resolve escalations with exemplary customer service.

Your work helps ensure fair, consistent outcomes for customers while supporting MetLife’s commitments to quality, risk management, and operational excellence.

Key Responsibilities

Lead timely, and accurate LTD claim evaluations and decisions in accordance with plan provisions, Create thorough claim documentation and correspondence by analyzing medical, occupational, financial, and policy information to support well‑documented determinations. Oversee claim evaluations by identifying and reconciling inconsistencies, leveraging Fraud, Waste and Abuse resources, and resolving escalated customer concerns while referring matters to appeals, complaints, or litigation support as needed.

Manage communication with claimants, customers, providers, attorneys, brokers, and family members by delivering clear, timely updates on claim status, determinations, and complex benefit calculations. Coordinat e with internal and external partners, including physicians, attorneys, vocational consultants, and CPAs, to obtain and evaluate information required for thorough and defensible claim decisions.

Required Qualifications

3+ years of LTD Insurance Claims experience Creative problem-solving abilities and the ability to think outside the box with independent judgement and decision making while relying on the available facts with the use of critical thinking and analysis when reviewing the information. Excellent interpersonal and communication skills in both verbal/written form and excellent customer service skills proven through internal/external customer interactions with demonstrated conceptual thinking, risk management, ability to handle complex situations effectively with organizational and time management skills Experience utilizing AI in a professional setting

Preferred Qualifications

Bachelor’s degree and knowledge of STD/FML, state leave laws, worker’s compensation, ERISA, and Social Security The expected salary range for this position is $58,000 - $69,000 . This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.