Description et exigences
Location - Virtual
Shift: Wednesday - Sunday (Monday & Tuesdays off)
Shift Hours - 8-4:30pm or 9-5:30pmEDT.
Position Overview:
The Claims Team Lead will work directly on the Claims floor and serve as a conduit between the Claims Supervisor and the Claims team. The Team Lead is responsible for advanced knowledge of MetLife Pet/PetFirst coverage, policies, and procedures as well as having the ability to interpret, code and understand medical terminology in relation to diagnoses and procedures. The Team Lead must also be able to accurately relay this information to the team. The Team Lead will work closely with the Customer Experience and Sales Team Leads to address and resolve customer issues related to claims. The Team Lead will coach team performance and work with their Manager to ensure team production and service goals are consistently met.
This role requires a high energy person capable of strategic thinking and leadership, problem solving, multi-tasking as well as attention to detail in day-to-day operational procedures.
Essential Duties and Responsibilities:
· Provide daily direction and communication to claims associates to ensure the team is performing optimally
· Expeditiously and efficiently resolve customer escalated issues resulting from claim adjudication which may result in email or phone communication with the customer or vet
· Provide policy clarification to claims associates
· Coach claims’ associates behaviors toward the company’s goals and assist Manager with gathering information for performance reviews
· Monitor real-time associate activity and address production and quality issues as needed
· Perform administrative tasks including, but not limited to, customer escalations, inter-department communication and claims adjudication requests.
· Assists Supervisor with analyzation and presentation of department metrics
· Adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements
· Procures and maintains adjuster’s license in all relevant states
· Perform all other duties as assigned
Essential Knowledge, Skills, and Abilities:
Required:
· High school diploma or GED
· Three years veterinary medical experience or equivalency required
- 4+ years pet insurance adjuster experience
- Proven leadership experience and conflict management skills
- P&C License Required as a condition of employment (must be obtained within 3 months of hire)
Preferred:
· Strong understanding of veterinary medical terminology (Vet Tech License a plus)
· Articulate, professional, and possesses a strong quality customer service mindset with attention to detail with excellent tracking, follow-up, and relationship building skills
· Ability to identify problems and logically research with minimum assistance to locate answer through appropriate reference materials
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!