Senior Insurance Claims Specialist - Life&Health

• Manage complex life, health, and disability claims end-to-end, from assessment and benefit determination through payment and final resolution.
• Make sound, well-documented claims decisions and communicate outcomes clearly and empathetically to customers and beneficiaries.
• Provide technical expertise on complex claims, policy interpretation, and benefit determination, supporting colleagues when needed.
• Ensure claims are managed in line with policy provisions, regulatory requirements, risk, fraud prevention, KYC/AML, data protection, and internal controls.
• Partner with medical advisors, reinsurers, distribution teams, and internal functions to deliver effective, customer-focused outcomes.
• Monitor claims performance and trends, identify root causes, and drive improvements in quality, efficiency, and customer experience.
• Identify opportunities to simplify, automate, and digitalize claims processes, using approved AI tools responsibly and critically.
• Contribute to claims governance, system implementations, automation, and transformation initiatives, sharing best practices across the team.

• 3+ years of experience in Life and/or Health Claims, including managing complex claims.
• Strong knowledge of insurance products, policy terms, claims assessment, and decision-making.
• Ability to interpret medical, financial, and legal documentation and make sound, well-supported decisions.
• Strong analytical, problem-solving, and prioritization skills, with a continuous improvement mindset.
• Customer-focused approach, balancing customer needs, risk considerations, and business objectives.
• Strong ownership, communication, collaboration, and stakeholder management skills, including in sensitive or challenging situations.
• AI fluency, with the ability to use approved AI and digital tools responsibly, critically evaluate outputs, and identify opportunities for greater efficiency and automation.
• Intermediate to advanced English and strong Microsoft 365 skills.

• University degree in Medicine, Economics, Law, Finance, Insurance, or another relevant field.
• Experience leading or participating in digital transformation, process improvement, or claims automation initiatives.
• Previous experience in AI-powered productivity tools (e.g., Microsoft Copilot, ChatGPT, Claude) and the ability to apply them to enhance operational efficiency and customer outcomes.
• Lean, Six Sigma, Agile, or other continuous improvement certifications and experience working in cross-functional change initiatives.
• A curious, improvement-oriented mindset and enthusiasm for using technology.

Benefits We Offer

Our benefits address holistic wellbeing with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan paid for by the company and access to a private medical subscription, as well as free counseling through our Employee Assistance Program (EAP). You’ll also enjoy a hybrid way of work with flexible hours, meal vouchers, an annual performance bonus, and a vacation bonus. In addition to your standard paid time off, you also get one “special day” off, a sick day, and extra vacation days based on seniority.

About MetLife