Claim Reviewer Job at MetLife, Oriskany, NY

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  • MetLife
  • Oriskany, NY

Job Description

Job Location: Must be commutable distance to Oriskany NY Office In office once a month for meetings Summary of Responsibilities: Review Group Life claims submission for completeness and accuracy. Records data in the Group Life Claims system for adjudication and determines if claim documentation will need to be reviewed by a Claim Examiner. Respond to written and/or telephone inquiries timely. Place call outs to Claimants to assist with he claims process. Functional Responsibilities: · Checks Group Life claim documentation or other company forms for completeness and accuracy. · Evaluate Group Life claim submissions for accuracy to ensure correct claim payment. · Evaluate Group Life claim submissions to identify situations requiring referral to Claim Examiner. · Reviews data from various sources, including policyholders; translates it into appropriate media for input into a Windows based computer system (BIOS). · Respond to written and/or telephone inquiries from policyholders, beneficiaries, attorneys and families of deceased employees. · Provide guidance to beneficiaries on claim processes and resolve customer issues swiftly and thoroughly. · Completes all work within turnaround time to meet department and customer objectives. · Maintain production and quality standards. · Ensure compliance with state regulations for Group life claims by sending appropriate notifications. · Perform support functions as needed. · Provide high quality, timely service to policyholders, beneficiaries, attorneys, families of deceased employees and administration; resolve customer issues swiftly and thoroughly by offering recommendations and solutions. · Mentor Reviewers as needed · Provide compassionate call outs to claimants to assist with the claims process and offer additional services. Equal Employment Opportunity/Disability/Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace.

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