MetLife

Key Responsibilities:  

• Supports and guides assigned team members to ensure that they have the knowledge, skills, tools, and resources to be successful as defined by MetLife and our customers. 
• Clearly articulate the vision of success at the team and organizational level, how each role, and individual contributes to the aligned goals and objectives. 
• Identify, remove, and challenge barriers related to claims management. Escalate to senior leaders in the organization as appropriate along with recommended solutions.
• Evaluate and manage team accountability by providing positive reinforcement or development opportunities to team members that are directly linked to their behaviors and performance objectives.
• Intervenes as required to address acute gaps in performance, either of individuals on the team, or the team as a whole. 
• Perform people management duties that include one on one sessions to address metrics reviews and career development. Ensure 100% compliance of mandatory training courses. 
• Exhibits excellent interpersonal and communication skills in both verbal and written form with customer service proven through internal and external interactions. 
• Drives Claim Management Accuracy and customer experience through support of the quality program utilizing claim file reviews and call monitoring to identify improvement opportunities, gaps in knowledge, trends for quality, service and/or compliance.
• Accountable for team correctly performing claim adjudication with the focus on Decisional, Financial, Claims Coding and Compliance Accuracy in accordance with the Customers’ plan/policy and regulations.
• Ensures team accurately sets up and administers all applicable concurrent claims based on the customers plan and/or policies to include but not limited to; Short Term Disability, Family and Medical Leave, Paid Family and Medical Leave, Statutory Disability and/or employer sponsored benefit leaves.
• Facilitates regular team huddles/team meetings to evaluate inventory management through demand and capacity, provide process updates, communicate organizational news and other related topics.
• Effectively managing team to provide a high-level of service to our customers such as delivering on our commitments, ensuring timely return of phone calls, and adhering to customer goals,
• Mitigate risk by ensuring the team is applying all appropriate plan provisions and making accurate and timely.

Essential Business Experience and Technical Skills: 

Required: 

• 2+ years of Disability and/or Absence Management experience, 
• A comprehensive understanding of disability and/or absence management contractual provisions,
• Strong communication skills, including the ability to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim. 
• Basic knowledge of medical conditions, treatments, prognosis and FMLA and/or PFML requirements,
• Critical-thinking skills
• Ability to give and receive feedback to and from partners, 
• Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy,
• Prioritization and time management sills – the ability to juggle multiple items at the same time and complete items on time,
• Ability to Partner with Internal/External Customers

Preferred:

• Associate Degree
• 2 plus years of hands-on claims management experience preferably
• 5 plus years of Management
• Proficient in Microsoft Office Suite