Claim Examiner – Life Full Time NEW

Description and Requirements

The Team You Will Join

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 Opportunity

Location: Virtual (must live within a commutable distance to Oriskany, NY – Central NY)

On-site Requirements:

• Hybrid training: 2–3 days per week in office
• Monthly in-office team meetings

Position Summary

The FEGLI Life Claims Specialist is responsible for evaluating, adjudicating, and processing Federal Employees’ Group Life Insurance (FEGLI) claims. This role requires strong analytical skills, excellent customer service, and the ability to navigate sensitive, complex claim situations with professionalism and empathy.

Key Responsibilities

• Claims Evaluation & Processing
• 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.
• Customer Interaction & Communication
• 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.
• Collaboration & Support
• 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.
• Documentation & Systems
• 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.

Required Qualifications

• Strong analytical, organizational, and decision-making skills.
• Excellent written and verbal communication skills with a customer-focused approach.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency in Microsoft Word and Excel; strong data entry skills required.
• Ability to handle sensitive situations with empathy, patience, and professionalism.
• Willingness to work overtime, including weekends, as needed.

Preferred Qualifications

• College degree or equivalent relevant experience.
• Prior life insurance or claims experience highly desirable.

Competencies

• Demonstrates MetLife values and commitment to customer-focused service.
• Able to introduce and support process improvements.
• Works collaboratively, shares best practices, and supports team goals.
• Accountable for follow-through and meeting business objectives.
• Projects empathy, patience, and professionalism with all customers.
• Able to work periodic overtime, including weekends.

The expected salary range for this position is $47,000 . This role may also be eligible for annual short-term incentive compensation and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms.

Benefits We Offer

Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, paid time off, paid holidays, volunteer time off, tuition assistance and much more!

About MetLife

Recognized on Fortune magazine’s list of the “World’s Most Admired Companies”, Fortune World’s 25 Best Workplaces™, as well as the Fortune 100 Best Companies to Work For®, 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!

MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law (“protected characteristics”).

If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.

MetLife maintains a drug-free workplace.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.