MetLife

Essential Functions

Operational Responsibilities

·        Review and process incoming claim requests as per standard operating procedures (SOPs).

·        Validate case information, verify coverage, and determine preliminary eligibility.

·        Identify incomplete or inconsistent information and conduct additional research to resolve discrepancies.

·        Structure and set up cases across leave and disability lines

·        Ensure timely issuance of acknowledgment communications to employees and employers.

·        Update and maintain accurate data in internal systems (e.g., administration tools, workflow tools).

·        Support internal teams by preparing files for adjudication.

Communication Responsibilities

·        Draft clear, concise, and templated email responses to employees, employers, and internal partners.

·        Collaborate with stateside teams, quality teams, and subject matter experts to resolve escalations.

Quality, Compliance & Productivity

·        Meet daily/weekly/monthly performance targets as defined by SLA and internal metrics.

·        Ensure that all transactions meet quality standards set by Quality Assurance.

·        Maintain compliance with regulatory requirements (e.g., FMLA guidelines, state disability rules, HIPAA principles where applicable).

·        Maintain attendance and adhere to schedule commitments.

Other Functional Requirements

·        Work collaboratively as part of a team, supporting business goals.

·        Adapt to process updates, system changes, and evolving client requirements.

·        Utilize MS Office and other productivity tools to improve efficiency.

·        Perform additional tasks or responsibilities assigned by the supervisor as needed.