Claims Specialist Jobs

About The Position

Requirements

• Be within commutable distance of Tampa, Florida.
• High school diploma and ability to apply foundational business knowledge to evaluate claims and communicate decisions clearly and professionally.
• Experience using business systems and documentation tools to manage claim files, track activity, and produce accurate written correspondence.
• Strong critical thinking, sound judgment, and analytical decision-making skills, with ability to work independently in a fast-paced environment.
• Excellent communication, customer service, organization, and professional writing skills, with a proactive and solution-oriented approach.

Nice To Haves

• Bachelor’s degree.
• 3 to 5 years of related professional business experience.
• Individual Disability Income claims experience.
• Familiarity with FINEOS, including navigation, case management, and claims processing functions.

Responsibilities

• Manage a caseload of pending, ongoing, and appeal reviews, ensuring timely, accurate, and well-reasoned claim determinations in a high-volume environment.
• Gather and evaluate medical, financial, occupational, and stakeholder information to support informed decisions.
• Document claim files and correspondence clearly and in detail; analyze evidence, identify gaps, and reconcile inconsistencies to produce defensible outcomes.
• Coordinate communication with insureds, attorneys, brokers, and internal and external partners; explain claim decisions, resolve issues, and ensure stakeholder alignment.
• Calculate and oversee benefit payments and financial components, including offsets and non-routine payments.
• Maintain accurate records and resolve escalated concerns, including regulatory and executive inquiries.

Benefits

• Medical and prescription drug coverage
• Vision insurance
• Dental insurance
• No-cost short- and long-term disability coverage
• 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, and accident insurance
• Employee Assistance Program and digital mental health programs
• Parental leave
• Paid time off
• Paid holidays
• Volunteer time off
• Tuition assistance
• Annual short-term incentive compensation and stock-based long-term incentives may be available, subject to applicable plan terms.