- Posting Location: Bridgewater, New Jersey
- Posting Location: Philadelphia, Pennsylvania
Role Value Proposition
• Single point of contact for Absence Programs questions, issues or concerns for a Fortune 500 company located in Camden, NJ.
• Responsible for the expedient management and resolution of customer-initiated claim escalations, inquiries, or claim processing questions while ensuring the highest level of customer satisfaction.
• Associate will be onsite with the customer at their Camden, NJ location as part of a hybrid schedule. Associate will be an extension of the customer’s Benefits Operation Team, learning about their culture and processes while acting as a liaison with the MetLife Disability Claim Team.
Key Responsibilities
Single point of contact for the customer in supporting Short Term Disability, Long Term Disability and Leave of Absence programs:
• Support daily operations and administration of Disability and Leave of Absence claims
- Clarify claim statuses and action items by coordinating multiple internal stakeholders at the customer: Leaves Team, HR at locations, Corporate HR Team
- Provide advice on additional actions that need to occur to resolve inquiries
- Respond to questions from the MetLife claim team to assist with claim processing which could include verifying FMLA eligibility within the customer’s system, identifying reasons for late certifications, etc.
- Be able to explain rationale for claim decisions
- Share knowledge of state laws, statutory benefits and ADA.
• Interact directly with the customer’s HR Team, internal and external stakeholders
• Utilize MetLife systems to clarify open questions about terminations, dates of leave or return to work
- Provide clarification on claim dates, if needed
- Research complex claim scenarios and recommend the appropriate next actions for resolution utilizing all system and personnel resources available
- Liaison partnership with Employment Law Team as required
- Initiate customer Managing End of Leave process and support HRBP as needed
• Utilize Disability expertise to partner with the customer on improving current processes
- Leverage industry and Disability process knowledge to provide recommendations for potential service and process improvements.
- Identify trends, provide analysis to the customer and MetLife team with recommendations
• Act as a customer advocate for the customer’s employees
- Investigate and resolve customer questions and concerns raised by customer’s HR Team on behalf of their employees.
- Maintain a log of all inquiries to allow tracking of volume and type of inquiry
- Help customer to understand root cause and trend analysis of inquiries. Assist with development of individual claim resolution action plans.
- Summarize individual claim data to identify overarching process changes focused on improving claimant satisfaction, processing accuracy and efficiency.
- Provide proactive approach to issue resolution
- Leverage relationships within customer and MetLife while using appropriate systems to quickly resolve questions
- Research claim status and return to work date prior to processing payments to prevent overpayments.
Essential Business Experience and Technical Skills
• High school diploma, Bachelors degree preferred
• 3+ years Disability claims management experience, including knowledge of other Employee Benefit programs (e.g., Workers Compensation, Life Insurance) and relative Federal and State Laws.
• Knowledge of all Disability product lines (STD, LTD, FMLA, statutory claims) and ADA required.
• Possess basic knowledge of Microsoft tools (Excel, Project, PowerPoint).
• 5+ year’s experience leave working with a public company and working knowledge of Human Resource
• Knowledge of Workday and UKG systems