Claims Examiner

at  MetLife

Working Schedule
Full-Time
Work Arrangement
Hybrid
Relocation Assistance Available
No
Posted Date
17-Oct-2024
Job ID
4934

• Claims management tasks;
• Recording of claims received from the mailroom or electronically;
• Checking the completeness of the claim, obtaining missing documents;
• Consultation with the employer’s medical experts, supervisors and legal department;
• Liaising and cooperating with other departments of the employer;
• Correspondence with clients, business partners, brokerage partners, authorities, medical institutions;
• Recording claims in computerised registration systems (LIFE, Claims system);
• Calculation, training and recording of contingency reserves, consultation with actuaries;
• Assessing the validity of claims. Deciding on the payment or rejection of claims up to the limit of the amount of the current authorisation. Preparing decisions above the level of eligibility, taking them to the appropriate decision-making level;
• Handling of claims rejection;
• Proposing the payment of claims;
• Management of computerised systems for loss and damage reporting;
• Archiving of claims documentation;
• Participation in the handling of complaints;
• Liaising with brokerage partners under contract with the insurer and, in the case of group contracts, with the HR departments of the contracting companies;
• Monthly tasks:
• Monitoring of pending service claims, correspondence;
• Maintenance of annuity services;
• Maintenance of policies exempt from premiums due to disability or death;
• Monitoring of time-barred claims;
• Get involved in other different tasks, in order to develop your skills and knowledge.