Claim Reviewer - 13202

Description and Requirements
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.
Location: Must live within a commutable distance of the Oriskany NY office (Central NY)
In office once a month for in office meetings
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:
1. Receive and handle telephone calls on the FEGLI customer service 800 #.
2. Make return telephone calls as required to handle the original customer inquiry.
3. 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.
4. 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.
5. 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.
6. Clearly and concisely communicate content of inquiry and levels of urgency to data and CMS owners via phones slips and comments.
7. Send and receive (standardized) e-mail for communication with agencies/OFEGLI staff and managers.
8. Processing incoming mail for new and existing claims.
9. Write manual letters and correspondence on FEGLI life claims.
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.
The expected salary range for this position is $41,600 - $48,900. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.
Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces™, as well as the Fortune 100 Best Companies to Work For®, 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!
MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
If you need an accommodation due to a disability, please email us at [email protected]. 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.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
$41,600 - $48,900