Description and Requirements
LOCATION: Virtual, BUT MUST BE COMMUTABLE TO TAMPA, FL. TRAINING IS IN-OFFICE FOR 12 WEEKS.
Key Responsibilities:
· Manages assigned caseload of initial eligibility files with limited supervision.
· Utilizes critical thinking and independent judgment and analysis to provide timely, balanced, and accurate claims decisions in a time sensitive, compliance driven and fast paced environment.
· Compiles file documentation requiring extensive policy and factual detail.
· Identifies information and resources needed to make initial benefit eligibility determinations, to include review of detailed medical information and other documentation necessary for rendering initial eligibility decision.
· Communicates decisions to policyholders and or their representatives in both verbal and written form.
· Composes highly detailed letters to policyholders and or their representatives outlining status of review and basis of determination.
· Clarifies and reconciles inconsistencies.
· Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information.
· Engages with various medical and legal resources in situations where warranted.
· Represents MetLife at deposition and trial due to first party litigation environment.
Essential Business Experience and Technical Skills:
Required
· Strong communication skills, both written and oral
· Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
· Experience using MS office products
· Strong organizational skills.
· High School Diploma/GED and 3-5 years related experience
Preferred
· 2-4 years professional experience
The expected salary range for this position is $50,000 - $57,500. 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, paid time off, paid holidays, 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 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.
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.
