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MetLife

AMS Specialist

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Description and Requirements
Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and
state regulatory and/or company plan requirements and established FMLA workflow procedures
? Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee,
physicians office or employer through outgoing calls, email, fax or other supporting systems.
? Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans
and make initial claim decision.
? Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW
confirmation, return phone calls, etc.
? Update systems to accurately reflect leave status and ensure appropriate diary documentation exists
? Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures
? The position is expected to do absence management and adjudication on Federal, State and company leaves.
? Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees,
employers/customer and physician's office
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