Requirements

Description and Requirements

Job Description

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

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

Soft Skills

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

About MetLife

Recognized on Fortune magazine's list of the World's Most Admired Companies and Fortune World's 25 Best Workplaces™, 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 individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!

Sr Insurance Associate