Note: The job is a remote job and is open to candidates in USA. MetLife is one of the world’s leading financial services companies, providing insurance, annuities, and employee benefits. They are seeking a FEGLI Life Claims Specialist responsible for evaluating, adjudicating, and processing life insurance claims, requiring strong analytical skills and excellent customer service.
Responsibilities
- Obtain and verify all missing information required to evaluate FEGLI life insurance claims
- Interpret policy provisions and manually adjudicate claims within a payment authority up to $400,000
- Review claims to determine whether referral to a Complex Case Manager or Claims Quality Specialist is required
- Actively follow up on open claims and ensure timely resolution
- Maintain accuracy and compliance with production and quality standards
- Respond to written inquiries from policyholders, beneficiaries, attorneys, and families
- Provide clear guidance on claim procedures and resolve issues promptly
- Handle outbound calls related to claim servicing and support customer escalations from Customer Service Associates
- Research claim issues submitted through telephone referrals and provide timely responses
- Work closely with administrative staff to clarify plan provisions and resolve claim discrepancies
- Maintain strong rapport with internal and external customers through ownership, professionalism, and service-oriented communication
- Coach new Life Case Manager Specialists on procedures and workflow
- Provide UAT (User Acceptance Testing) support for system enhancements
- Document and update all claim activity using PowerBuilder, Livelink, EDCS, Accurint, Excel, Microsoft Word, and internal tracking systems
- Initiate investigations using internal and external resources (e.g., autopsy reports, toxicology, accident reports, medical records, missing beneficiary searches, homicide investigations)
- Stay current on FEGLI procedures through Livelink and required training
Skills
- Strong analytical ability and sound judgment in evaluating life claim submissions
- Excellent written and verbal communication skills
- Ability to manage multiple deadlines and shifting priorities in a fast-paced environment
- Proficiency in Microsoft Word and Excel; strong data entry accuracy
- Ability to maintain confidentiality and handle sensitive situations professionally
- Demonstrated customer service excellence and problem-solving skills
- College degree or equivalent relevant experience
- Prior life insurance or claims experience highly desirable
Benefits
- Comprehensive health plan that includes medical/prescription drug and vision
- Dental insurance
- No-cost short- and long-term disability
- Company-paid life insurance
- Legal services
- Retirement pension funded entirely by MetLife
- 401(k) with employer matching
- Group discounts on voluntary insurance products including auto and home
- Pet
- Critical illness
- Hospital indemnity
- Accident insurance
- Employee Assistance Program (EAP)
- Digital mental health programs
- Parental leave
- Paid time off
- Paid holidays
- Volunteer time off
- Tuition assistance
Company Overview
MetLife is a provider of insurance, employee benefits, and financial services . It was founded in 1868, and is headquartered in New York, New York, USA, with a workforce of 10001+ employees. Its website is http://www.metlife.com.