Sr. Individual 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 IDI Senior Claims Specialist is responsible for evaluating individual disability income insurance claims, making timely and accurate claim decisions, and delivering clear, customer-focused support in accordance with policy provisions and 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 make a meaningful impact in customers’ lives during important moments.

In this role, the applicant will apply independent judgment, critical thinking, and strong communication skills to manage moderately complex claims, collaborate with internal and external partners, and help deliver fair, thorough, and well-reasoned outcomes that support MetLife’s commitment to customers and communities.

Key Responsibilities

• Lead the evaluation and decision-making process for moderately complex individual disability income claims, including pending, ongoing, and appeal reviews, while applying independent judgment and ensuring timely, balanced, and accurate outcomes.
• Create clear, detailed, professional claim documentation, correspondence, and written communications that explain claim status, evaluations, determinations, and required next steps.
• Oversee the collection and analysis of medical, occupational, financial, policy, and claim-related information to identify gaps, clarify inconsistencies, and support logical and defensible claim determinations.
• Manage proactive communication with claimants, customers, representatives, healthcare providers, attorneys, brokers, and family members by demonstrating empathy, active listening, and clear explanations throughout the claim evaluation process.
• Develop well-reasoned claim decisions and benefit calculations by assessing offsets, COLA, Social Security offsets, residual disability, elimination periods, and non-routine payments in accordance with policy provisions and regulatory requirements.
• Coordinate with internal and external partners, including physicians, vocational consultants, CPAs, underwriting, Fraud Waste & Abuse, litigation support, and other stakeholders, to gather information and support thorough claim evaluations.

Required Qualifications

3+ years of IDI or LTD insurance claims experience, with the ability to apply policy provisions, claim practices, and independent judgment to evaluate moderately complex disability claims. Proficiency using multiple systems, technologies, and information sources simultaneously to review claim information, document actions, manage case activity, and support timely claim decisions. Strong critical thinking, analytical, communication, customer service, and organizational skills, with the ability to manage competing priorities and navigate complex or ambiguous claim situations.

Demonstrated professionalism, accountability, empathy, and sound judgment when working with claimants, customers, representatives, internal partners, and external stakeholders.

Preferred Qualifications

Bachelor’s degree. Familiarity with FINEOS, including navigation, case management, and claims processing functions. The expected salary range for this position is $70,000 - $85,000 .

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