Specialist

4 weeks ago


Noida, India MetLife Full time
  • 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

 

 



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