NOIDA · FULLTIME
Specialist
MetLife
Noida · onsite · Posted 38d ago
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Section · 01
About this role
- Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures
- Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee or employer through outgoing calls, email or other supporting systems.
- Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans and make initial claim decision.
- Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, return phone calls, etc .
- Update systems to accurately reflect leave status and ensure appropriate diary documentation exists
- Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures
- The position is expected to do absence management and adjudication on Federal, State and company leaves.
- Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician's office
- Analyze, validate and process transactions as per Desktop procedures (L3 & L4 )
- Analyze and research all discrepancies
- Research & Investigate and resolve outstanding items
- Determine eligibility , entitlement and applicable plan provisions while meeting timeliness goals
- Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside resources by email and outgoing calls
- Establish action plans for each file to bring claims to resolution
- Utilize internal and external specialty resources to maximize impact on each claim file
- Use PC programs to increase productivity and performance
- Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards
- Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
- Work as a team member to meet office goals to obtain disability's vision while demonstrating core values and
- Ensure adherence to established attendance schedules
- Close visual activity - viewing a computer terminal and extensive reading
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Section · 02
Skills
absence managementFMLAAdjudicationintermittent claim trackingrecertification of health condition
Section · Company
About MetLife
MetLife
Insurance
4k+
employees
2008
18 years old
New York
United States (USA)
₹9.3L PA avg
Avg at MetLife
About
As a global leader in protection planning, MetLife offers insurance and financial solutions, serving individuals and businesses in over 50 countries.
Industries
InsuranceFinancial Services
Employee ratings
10 reviews
4.0/ 5
Culture
3.5
Career growth
3.3
Work-life
3.7
Employees rate it well for
Job Security42Work-Life Balance42
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