MetLife

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 Senior LTD Change in Definition (CID) Claims Specialist is responsible for evaluating long-term disability insurance claims at critical transition points in the LTD lifecycle, including when the definition of disability changes, typically after 24 months of benefits. This role contributes to MetLife’s purpose by helping ensure claims decisions are timely, thorough, fair, and aligned with plan provisions, while supporting claimants through complex and meaningful moments in their disability journey 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 apply independent judgment, critical thinking, and strong customer service skills while managing a complex CID caseload. The successful candidate will conduct transition reviews, assess earnings capacity and functional status, evaluate return-to-work potential and vocational rehabilitation opportunities, and collaborate with internal and external partners to support well-reasoned claim outcomes.

·         Lead thorough and timely evaluations of complex long-term disability claims within the Change in Definition lifecycle, applying independent judgment and critical thinking to support fair and well-reasoned claim outcomes.

·         Create clear, accurate, and detailed claim documentation, correspondence, and recommendations that reflect policy provisions, factual information, regulatory requirements, and claimant-specific considerations.

·         Oversee the gathering and analysis of medical, occupational, earnings, and vocational information to determine whether additional details are needed to reach a reasonable claim determination.

·         Manage an assigned caseload of complex CID claims in a fast-paced, time-sensitive environment while maintaining quality, accuracy, and compliance with applicable state and department of insurance regulations.

·         Develop proactive, empathetic communication with claimants and/or their representatives by providing clear updates, direction, and explanations regarding the claim process, benefits, and relevant plan provisions.

·         Coordinate effectively with internal and external partners, including health care providers, attorneys, clinical and vocational consultants, customers, brokers, family members, and Fraud, Waste and Abuse resources, to reconcile inconsistencies and support thorough claim evaluations.

·         3+ years of LTD/IDI insurance claims experience evaluating complex disability claims, apply plan provisions, and make timely, well-reasoned claim decisions based on available facts.

·         Claims management systems and technology resources to document claim activity, review medical, occupational, earnings, and vocational information, and manage work efficiently across multiple platforms.

·         Strong critical thinking, independent judgment, risk management, and creative problem-solving skills to analyze complex information, identify inconsistencies, and determine appropriate next steps.

Customer-focused, organized, and collaborative professional with excellent verbal and written communication skills and the ability to manage competing priorities in a fast-paced environment.

•      Bachelor’s degree

•       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 and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms.