Description and Requirements
Job Responsibilities
- Scrutinizing dental claim documents & settlements
- Process claims as per the set healthcare guidelines
- 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
- Handle escalations
- Need to ensure quality and productivity targets are met
- Ensure compliance with internal policies and procedures, external regulations and information security standards
Knowledge, Skills and Abilities
Education
- Bachelor's degree (Any Stream) or diploma with a minimum of 15 years of education
Experience
- 2 years of work experience in US Health Claims processing preferably in claims adjudication
Knowledge and skills (general and technical)
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
Soft Skills
- Strong organizational skills
- Good communication skills
- 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
#BI-Hybrid
What the Team is Saying
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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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Hybrid Workspace
Employees engage in a combination of remote and on-site work.
MetLife's current workplace policies classify roles as Office, Hybrid or Virtual based on the nature of work, encouraging new ways of working together
