Absence Management Claim Specialist

On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement. Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide. Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time.

The Claim Specialist will be responsible for making decisions on claims. They will communicate with the employee, employer, and the health care provider to make sure everything that is needed for the claim is received. They will review all claims and will look to make decisions on these. They will handle a caseload of Absence Claims that will need to be managed with effeciency.

• Handle, review, and administer Family & Medical Leave Act / and or Americans with Disabilities Act(ADA) claims and adhere to federal and state regulatory and/or company plan requirements. Establish FMLA/ADA workflow procedures and evaluate against appropriate leave plans and make initial claim decisions.

• Complete eligibility decisions during intake call, gather pertinent data when necessary, from employee or other supporting systems as well as perform leave-ups as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, etc.

• Update systems to accurately reflect leave status and ensure appropriate diary documentation exists.

• High school diploma
• 1+ yrs. related experience and strong customer satisfaction focus and attention to detail

• Bachelor’s degree
• FMLA/ADA claims knowledge of process and procedures.