Premium Waiver Claims Examiner Job at MetLife, Remote

UWx5UmVnYlJhL2xWVllqVDl0enR3WmNveHc9PQ==
  • MetLife
  • Remote

Job Description

:

General Information

City/Cities Oriskany State(s) New York Country United States Working Schedule Full-Time Work Arrangement Virtual Commutable Distance Required Yes Relocation Assistance Available No Posted Date 02-Jan-2024 Job ID 1211

Description and Requirements

Location: New Hires Should live within a commutable distance of the Oriskany NY office (Central NY)

Reports to: Unit Manager - Premium Waiver

_____________________________________________________________________

Summary of Responsibilities:

Review, research and investigate new and ongoing Total and Permanent and Premium Waiver claims to determine if claim is payable in accordance with policy provisions. Initiate investigations to obtain medical and vocational evidence required for approval of claim. Provide customer service with empathy and patience on incoming and outgoing phone inquiries. _____________________________________________________________________

Principal Responsibilities:

1. Evaluate new and ongoing Total & Permanent (T&P) and Premium Waiver (PW) claims to determine MetLife's liability. 2. Interpret policy provisions to determine eligibility and make claim determinations. 3. Initiate investigations through both company and external contacts (i.e., employees, employers and physicians) to obtain medical and vocational evidence required for approval of claim. 4. Establish action plans for each file to bring claim to resolution within specified timeframes. 5. Evaluate claims to identify situations requiring referral to Senior Examiner. 6. Respond to written and/or telephone inquiries from policyholders, employers and physicians to resolve claim issues swiftly and thoroughly. 7. Maintain production and quality standards. 8. Utilize internal specialty resources to maximize impact on each file. 9. Manage and organize work to meet multiple deadlines and competing priorities to ensure department turnaround and customer satisfaction are met. 10. Understand and use PC programs to increase productivity and performance. 11. Utilize internal specialty resources to maximize impact on each file. 12. Keep up to date on Premium Waiver procedures and attending required training.

Knowledge/Skills/Competencies Required:

  • Excellent oral and written communication skills
  • Customer service experience in a professional work environment
  • Analytical ability and good judgment in evaluating claims
  • Strong Data entry skills and PC knowledge (Microsoft Word and Excel)
  • Ability to adjust and respond positively to multiple demands and shifting priorities
  • Understands the sense of urgency in claims management and business demands; knows when to act quickly and when to give decision more time and thought
  • Ability to plan and organize time and priorities to achieve business results
  • Works collaboratively with others, shares best practices and assists teammates with work
  • Ability to work periodic overtime
  • Strong attention to detail

Knowledge/Skills/Competencies Preferred:

  • Life and/or Disability insurance experience
  • Knowledge of medical terminology
  • College degree or relevant work experience desirable

At MetLife, we're leading the global transformation of an industry we've long defined. United in purpose, diverse in perspective, we're dedicated to making a difference in the lives of our customers.

Equal Employment Opportunity/Disability/Veterans

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.

Job Tags

Permanent employment, Full time, Work experience placement, Work at office, Relocation package, Shift work

Similar Jobs

ColumbiaCare Services

Residential Care Associate I - 5770 Job at ColumbiaCare Services

 ...Time Off for Mental HealthCompany Paid Life InsuranceSpontaneous & Longevity BonusesLoan Forgiveness Program EligibilityEmployee Assistance Program (EAP) & Tobacco Cessation ProgramVocational Training Program: Accelerated training path towards QMHA certification For... 

Hospice Of Hope, Inc

Hospice Aide STNA Night Shift - Inpatient Unit Job at Hospice Of Hope, Inc

 ...or move patients between wheelchairs, seats and beds Serve meals and help patients eat their food Assist in cleaning and housekeeping of rooms and facility Maintain par stock of supplies on hand Measure vital signs like blood pressure and temperature ... 

MARTIN Technologies

Propulsion NVH Technologist Job at MARTIN Technologies

 ...independently instrument vehicles and powertrains, operate NVH measurement systems, troubleshoot prototype systems, and work closely with engineers in a fast-paced development environment. What Youll Do Instrument, set up, and perform Noise, Vibration & Harshness (NVH)... 

Canonical

Remote Technical Author (multiple roles and seniority levels) Job at Canonical

 ...not traditional technical writer roles. As a Technical Author, you will lead the documentation efforts of a Canonical team, in engineering, business operations or another part of the company. You will combine excellence in technical communication with subject-matter... 

Carpet City Flooring Center - Wausau

Business Development & Sales Representative Job at Carpet City Flooring Center - Wausau

 ...customers Maintain relationships with existing accounts and identify additional opportunities for growth Manage the Sales Process Work with customers to understand their flooring needs, project requirements, timelines, and budgets Recommend flooring solutions...