The Team Leader administers STD claims, makes eligibility decisions, and manages claim processes while ensuring compliance and accurate documentation.
Description and Requirements
• Administer STD claims
• Complete eligibility decisions, gather pertinent data, when necessary, from employee, employer, physician's office or employer through outgoing calls, email, fax or other supporting systems.
• Promptly review new STD Claims and make initial & subsequent claim decisions.
• Perform discussion on health condition, RTW confirmation, return phone calls, etc.
• Update systems to accurately reflect claim status and ensure appropriate diary documentation exists
• Business recommended TAT to complete the activity within the required number of business days, specific to task types, to maintain compliance measures
• The position is expected to do end to end management including Statutory plans, Federal, Company, State and other Leave types .
• Interact with claim specialists, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician's office
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World's 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
#BI-Hybrid
• Administer STD claims
• Complete eligibility decisions, gather pertinent data, when necessary, from employee, employer, physician's office or employer through outgoing calls, email, fax or other supporting systems.
• Promptly review new STD Claims and make initial & subsequent claim decisions.
• Perform discussion on health condition, RTW confirmation, return phone calls, etc.
• Update systems to accurately reflect claim status and ensure appropriate diary documentation exists
• Business recommended TAT to complete the activity within the required number of business days, specific to task types, to maintain compliance measures
• The position is expected to do end to end management including Statutory plans, Federal, Company, State and other Leave types .
• Interact with claim specialists, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician's office
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World's 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
#BI-Hybrid
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Top Skills:
Ada Administration SystemsEligibility Decision Software
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