Specialist.

2 weeks ago


Noida, India MetLife Full time

Job Responsibilities

Analyze and process claims in a productive environment through our TLC claim system, SIR, plan specs and

specimen policy

Appropriately interpret a variety of plan provisions and process claims accordingly, calculating claim payments and

overpayments

Review claims for receipt of all needed documentation and make outbound calls to providers for additional

information

Collaborate with our Claim Support Specialists, Customer Call Center and Care Coordinators to provide a seamless

claims experience

Abide by department guidelines and appropriately follow up on necessary tasks to process claims Meet quality review standards of processed claims Meet performance standards for financial accuracy, processing accuracy and claim timeliness

Respond to insured inquiries regarding specific claim details via telephone conversations and/or written

correspondence

Gather and analyze information skillfully to identify and resolve problems in a timely manner

Education, Technical Skills & Other Critical Requirement

Education

Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.

Experience

(In Years)

3-4 Years

Technical Skills/other skills

Computer navigation skills Excellent Keyboarding and data entry speed Knowledge of Insurance principles in relation to the US Insurance industry is preferred Good verbal/written communication skills – should be able to read, interpret business documents Excellent analytical, mathematical and interpersonal skills Data gathering ability/ Eye for detail Ability to comprehend and apply varied rules to multiple policies Team work/ Managing Self / Adaptability Ability to work successfully and perform detail-oriented work in production driven environment Excellent organizational skills Proven ability to meet quality and time standards Ability to work on routine/standardized transactions Ability to be flexible with regard to process changes
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