Sr Insurance Associate
MetLife · Noida · onsite · Posted 35d ago
Not disclosed2–4 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
- Scrutinizing dental claim documents & settlements
- Process claims as per the set healthcare guidelines
- Respond to customer requests via multiple sources, providing excellent service to MetLife's customers who have insurance or other financial service products or benefit plans.
- Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.
- Follow HIPAA guidelines
- Accurate processing of Dental claims and meeting productivity targets
- Good understanding of Claims adjudication fundamentals
- Good understanding of ICT & CPT Codes
- Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
- Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
- Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer's inquiry.
- Handle escalations
- Need to ensure quality and productivity targets are met
- Ensure compliance with internal policies and procedures, external regulations and information security standards
Education
- Bachelor's degree (B.com,BBA,BA,BSC) or diploma with a minimum of 15 years of education except specialized skills like BCA ,BTech ,Medical Graduates etc.
- 2 years of work experience
Technical Skills
- Computer navigation skills
- Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
- Working knowledge of MS Excel and MS Word.
- Process Specific Skills
- Knowledge of Insurance principles in relation to the US Insurance industry
- Knowledge about US Culture
- Knowledge of Dental claims terminologies and processes will be an added advantage
- Written- External/Internal (Free Flow) Email Writing
- Free flow correspondence creation
- Excellent comprehension skills – Interpret/analyze data from various resources , understands , documents and responds appropriately
- Strong organizational skills
- Excellent Language skills (written ,verbal and comprehension)
- Demonstrate ability to work independently and in a team environment
- Self-disciplined and results oriented
- Ability to multi task
- Strong understanding and comprehension of the English language
- Good PC skills
- Attention to detail
- Team player
- Positive attitude
Internal Contacts
(And Purpose Of Relationship)
- AM/TL for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support as well as associate development.
- Manager for the purpose of settling issues left unresolved by the AM/TL and monthly evaluation of performance.
- Quality Compliance Analyst (QCA) for the purpose of feedback and audit.
- Trainers for the purpose of pre-process and process training.
(And purpose of relationship) – If Applicable
- MetLife Subject Matter Experts for the purpose of seeking missing information.
- MetLife Subject Matter Expert for the purpose of work-related issues and escalated transactions.
Sourced from foundit
Skills
Good understanding of Claims adjudication fundamentalsGood understanding of ICT CPT CodesKnowledge of Dental claims terminologies and processesKnowledge of policy concepts like Deductible coinsurance copay out of pocketWorking knowledge of MS Excel and MS WordComputer navigation skillsKeyboarding and data entry speed minimum 30 wpm with 90 accuracyKnowledge of Insurance principles in relation to the US Insurance industryFree flow correspondence creationWritten- External Internal Free Flow Email Writing
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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