Job Description

Basic Function
\xef\x82\xb7 Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and
state regulatory and/or company plan requirements and established FMLA workflow procedures
\xef\x82\xb7 Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee,
physicians office or employer through outgoing calls, email, fax or other supporting systems.
\xef\x82\xb7 Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans
and make initial claim decision.
\xef\x82\xb7 Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW
confirmation, return phone calls, etc.
\xef\x82\xb7 Update systems to accurately reflect leave status and ensure appropriate diary documentation exists
\xef\x82\xb7 Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures
\xef\x82\xb7 The position is expected to do absence management and adjudication on Federal, State and company leaves.
\xef\x82\xb7 Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees,
employers/customer and physician\xe2\x80\x99s office Essential Functions:
\xef\x82\xb7 Analyze, validate and process transactions as per Desktop procedures (L3 & L4)
\xef\x82\xb7 Analyze and research all discrepancies
\xef\x82\xb7 Research & Investigate and resolve outstanding items
\xef\x82\xb7 Determine eligibility, entitlement and applicable plan provisions while meeting timeliness goals
\xef\x82\xb7 Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside
resources by email and outgoing calls
\xef\x82\xb7 Establish action plans for each file to bring claims to resolution
\xef\x82\xb7 Utilize internal and external specialty resources to maximize impact on each claim file
\xef\x82\xb7 Use PC programs to increase productivity and performance
\xef\x82\xb7 Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards
\xef\x82\xb7 Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
\xef\x82\xb7 Work as a team member to meet office goals to obtain disability\xe2\x80\x99s vision while demonstrating core values and
meeting key measures
\xef\x82\xb7 Ensure adherence to established attendance schedules
\xef\x82\xb7 Close visual activity - viewing a computer terminal and extensive reading MetLife:
MetLife, through its subsidiaries and affiliates, is one of the world\xe2\x80\x99s leading financial services companies, providing insurance, annuities, employee benefits and asset management to help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.
We are ranked #44 on the Fortune 500 list for 2019. In 2019, we were named to the Dow Jones Sustainability Index (DJSI) for the fourth year in a row. DJSI is a global index to track the leading sustainability-driven companies.
MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.
MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.