LTD Appeal 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 Disability Appeal Specialist is responsible for reviewing denied claims and complete a fair, independent assessment and a thorough holistic review of the file and assessing the claim for accuracy by evaluating plan provisions and services rendered along with historical research. You will follow State Regulations and ERISA guidelines when processing files.

Keeping things timely to prevent risk. This is an exciting opportunity to utilize investigative skills, analysis data for accuracy and make a difference by providing the right decision. Success in this role requires attention to detail, ability to multi-task and engaging the right resources. The Disability Appeal Specialist is responsible for gather facts and data during the course of investigation for further consideration and follow ERISA guidelines.

You’ll collaborate closely with members of the Appeal team, your team lead, and claim resources in an environment where every contribution is respected, and every perspective is heard

Key Responsibilities

• Manage claim files with accuracy and conduct comprehensive review taking into consideration contract provisions, history of payment, plan limitations and clinical information with ability to research guidelines for accuracy.
• Caseload Management across multiple systems in order to make timely decisions according to ERISA.
• Create and prepare clear and concise written correspondence where applicable with claimants, policyholders in a timely manner.
• Coordinate with other team members to move workload with a once and done concept.
• Perform related duties and task as assigned.

Required Qualifications

The role is virtual, however, if candidate resides within commutable distance of an office, they will be required to come into the office once a month for team days 3-5 years Disability Claim Background with preference in appeal handling Prioritization Skills, Multi-tasking Skills, and attention to detail Builds and maintains strong relationships with direct team and other internal partners with excellent communication skills (oral and written) as well as willingness to accept change and provide constructive feedback where applicable Experience utilizing AI in a professional setting

Preferred Qualifications

Ability to utilize and manage different web based systems. Understanding of Disability plans Ability to perform in a production environment. Team player The expected salary range for this position is $64,500 - $67,000 .

This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.