Role Value Proposition:
Investigates long-term care claims and makes determination on claims settlement within authorized guidelines.
- Follows established policies and practices to resolve claim issues.
- Reviews claim data to make claim settlement decisions.
- Responsible for quality check of claims processed in the claim system for processing and financial accuracy.
- Reviews bills/invoices for evidence of fraud.
- Appropriately escalates issues to the supervisor for resolution as needed.
- Performs other related duties as assigned or required.
Essential Business Experience and Technical Skills:
- High School diploma
- 2 years of claims experience
- Associate level or higher degree preferred
- Excellent analytical and mathematical skills
- Ability to pay attention to detail
- Ability to comprehend and apply varied rules to multiple policies
- Ability to work in a fast-paced environment
- Works well in a team environment
- Excellent organizational skills
- Proven ability to meet quality and time standards
- Basic knowledge of computer system, Microsoft Word, and Excel
“At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose
MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies, providing insurance, annuities, employee benefits and asset management to help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.
We are one of the largest institutional investors in the U.S. with $651 billion of total assets under management as of September 30, 2020. We are ranked #48 on the Fortune 500 list for 2020. In 2019, we were named to the Dow Jones Sustainability Index (DJSI) for the fourth year in a row. DJSI is a global index to track the leading sustainability-driven companies.
MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.
We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife. For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.
MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.
MetLife maintains a drug-free workplace.
Requisition #: 116815