Claim Reviewer - 5116

Posted 2 Days Ago
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Oriskany, NY
Hybrid
42K-43K Annually
1-3 Years Experience
Fintech • Information Technology • Insurance • Financial Services • Big Data Analytics
At MetLife, we’re a purpose-driven company that helps our customers build a more confident future.
The Role
The Claim Reviewer is responsible for handling customer inquiries via phone and email, processing claim submissions, and maintaining accuracy in the claims system. Tasks include reviewing claims, managing communications, and ensuring timely responses to customer inquiries.
Summary Generated by Built In

Description and Requirements
Job Location: Must be commutable distance to Oriskany NY Office
Summary of Responsibilities:
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.
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Principal Responsibilities:

  • Receive and handle telephone calls on the FEGLI customer service 800 #.
  • Make return telephone calls as required to handle the original customer inquiry.
  • 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.
  • 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.
  • 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.
  • Clearly and concisely communicate content of inquiry and levels of urgency to data and CMS owners via phones slips and comments.
  • Send and receive (standardized) e-mail for communication with agencies/OFEGLI staff and managers.
  • Processing incoming mail for new and existing claims.
  • 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.
    ________________________________________________________________________
    Other Comments:
    Process all claim submissions within timeframe determined in business objectives.
    Respond to written and/or telephone inquiries timely.
    Meet quality standards to ensure department and customer guarantees are met.
    Meet production standards to ensure unit cost goals are obtained.
    The salary range for applicants for this position is $41,600 - $42,800.
    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 2024 "World's Most Admired Companies" as well as the 2024 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 empathy, we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
    Equal Employment Opportunity/Disability/Veterans
    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.
    $41,600 - $42,800

    What the Team is Saying

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    The Company
    HQ: New York, NY
    43,000 Employees
    Hybrid Workplace
    Year Founded: 1868

    What We Do

    Named one of Fortune’s “World’s Most Admired Companies,” MetLife is leading the global transformation of an industry we’ve defined for more than 150 years. At MetLife, every innovation and line of code is a lifeline for our customers and their families—from victims of natural disasters to people living with disabilities and beyond.  With operations in more than 40 markets and leading positions across the globe, MetLife’s building a workforce of diverse and empowered voices that all belong.  Join our remarkable journey—one in which you help write the next century of innovation in financial services—because with MetLife, making the world a better place is All Together Possible.

    Why Work With Us

    At MetLife, you’ll be working for a company whose purpose is to help customers throughout their life’s journey, and often in their most critical time of need. You’ll be a part of developing leading-edge platforms that will have a lasting impact on the lives and well-being of tens of millions of customers.

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