Life Claims Reviewer

at  MetLife

Location(s)

• Posting Location: Oriskany, New York

City/Cities
Oriskany
Posting Region/States
New York
Country
United States
Working Schedule
Full-Time
Commutable Distance Required
Yes
Relocation Assistance Available
No
Posted Date
29-Oct-2024
Job ID
5116

KNOWLEDGE/SKILLS/COMPETENCIES REQUIRED:

§ High school diploma required. Associates Degree desired
§ 1-2 years insurance claims experience desirable.
§ Basic knowledge of Group Life claims desirable.
§ Strong data entry skills required.
§ Excellent oral and written communication skills.
§ Ability to adjust to multiple demands and shifting priorities.
§ Consistently demonstrates the MetLife values.
§ Plans and organizes time and priorities to achieve business results.
§ Uses business knowledge to make the best decisions for MetLife and its customers.
§ Shows commitment to team objectives and assists teammates with work.
§ Presents information in a clear and organized manner.
§ PC knowledge required.
§ Ability to work overtime required.
§ Good oral communication skills.
§ Work with confidential files.
§ Ability to manage workload to meet tight deadlines.

SUMMARY OF RESPONSIBILITIES:

Responsible for receiving and handling customer telephone inquiries. Perform follow-up activity (send a letter, return a call, refer a case) as applicable. Review claims submission for completeness and accuracy. Records data in the Claims system for adjudication and payment to the Beneficiary. May also be responsible for setting up new claims, processing incoming mail, and handling expired call-ups.

PRINCIPAL RESPONSIBILITIES:

• Receive and handle telephone calls on the FEGLI customer service 800 #.
• Make return telephone calls as required to handle the original customer inquiry.
• Use FEGLI claims system to access information required to handle customer inquiries; identify OFEGLI case owners; enter comments into comment window; and complete and print or send phone slips as applicable.
• Build new claims as well as review and process noncomplex claims (such as single or multi beneficiary or dependent coverage’s) Consult with Manager on special customer inquiries.
• Determine if customer inquiry needs to be referred for follow-up. Review and determine next steps on expired call ups and perform any necessary follow-ups regarding the claim.
• Clearly and concisely communicate content of inquiry and levels of urgency to data and CMS owners via phones slips and comments.
• Send and receive (standardized) e-mail for communication with agencies/OFEGLI staff and managers.
• Processing incoming mail for new and existing claims.
• Write manual letters and correspondence on FEGLI life claims.