MetLife

Job Location: Virtual

Schedule:  This position requires work every weekend, Saturday AND Sunday. In return you will have two week days off, every week.

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

Preferred:

• Vet Tech License (HIGHLY PREFERED) 
• Ability to operate in a fast-pace, multi-tasking environment with deadlines
• Strong written, verbal, interpersonal, and phone communication skills
• Strong computer background using MS Word, Outlook, Excel, and Internet and ability to learn quickly (to include our proprietary CRM system for managing customers)

Business Category

Pet Team - Group Benefits_01022

Number of Openings

9

At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers.”