Job Description

Role Value Proposition:

The Claims Coordinator accurately reviews medical records and invoices, utilizing their understanding of pet health diagnoses and procedures, to evaluate coverage and equitably settle pet health insurance claims with respect to policy limits & terms. Communicates with the Insured, Veterinarian or Pet Adoption Agency to determine the details of the claim, requesting and verifying necessary documentation, and informs the Insured of claim status or claim outcome. Utilizes the workflow queues to perform job functions to include: claim entry/policy association, pre-adjudication, Insured/Veterinarian documentation requests, claim closeouts, claim appeals, and good to go claims processing.

Key Responsibilities:

* Requests and communicates with Insureds, Veterinarians, or Adoption Agencies for clarification of diagnosis/additional information necessary to accurately process claim
* Adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements. Follows adjudication policies and procedures to ensure proper payment of claims
* Documents phone calls in system and follows up on issues if needed
* Resolves problems resulting from claim adjudication and communicates claim status and claim outcome with Insureds
* Prepares reports as required by management and enters/receives inbound documents as assigned

Essential Business Experience and Technical Skills:

Required:

* High school diploma or equivalency
* Three years veterinary medical experience or equivalency preferred
* Strong understanding of veterinary medical terminology
* Proven history of adherence to corporate policies, procedures, and guidelines
* Proven Attendance Reliability
* Excellent tracking, follow-up, and relationship building skills

Preferred:

* Vet Tech License
* Ability to operate in a fast-pace, multi-tasking environment with deadlines
* Strong written, verbal, interpersonal, and phone communication skills
* Articulate, professional, and possesses a strong quality customer service mindset with attention to detail
* Strong computer background using MS Word, Outlook, Excel, and Internet
* Ability to learn quickly (to include our proprietary CRM system for managing customers)
* Ability to identify problems and logically research with minimum assistance to locate answer through appropriate reference materials

At MetLife, were leading the global transformation of an industry weve long defined. United in purpose, diverse in perspective, were dedicated to making a difference in the lives of our customers.

MetLife:

MetLife, through its subsidiaries and affiliates, is one of the worlds leading financial services companies, providing insurance, annuities, employee benefits and asset management to help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.

We are one of the largest institutional investors in the U.S. with $651 billion of total assets under management as of September 30, 2020. We are ranked 48 on the Fortune 500 list for 2020. In 2019, we were named to the Dow Jones Sustainability Index (DJSI) for the fourth year in a row. DJSI is a global index to track the leading sustainability-driven companies.

MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife. For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.

MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

MetLife maintains a drug-free workplace.