Reimbursement Coordinator – Virtual – MetLife

Job Location: Virtual within a commutable distance of Tampa FL

Summary of Responsibilities and Requirements:

Highly specialized job function that is responsible for claim analysis and claim processing for long term care services.  This position is also accountable for reviewing claims for accuracy, timeliness, completeness and eligibility for multiple groups with varied benefits.

Key  Responsibilities:

• Virtual roles predominately work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc.
• Analyze and process claims in a productive environment through our TLC claim system
• Appropriately interpret a variety of plan provisions and process claims accordingly, calculating claim payments and overpayments
• Review claims for receipt of all needed documentation and make outbound calls to providers for additional information
• Collaborate with our Claim Support Specialists, Customer Call Center and Care Coordinators to provide a seamless claims experience
• Abide by department guidelines and appropriately follow up on necessary tasks to process claims
• Meet quality review standards of processed claims
• Meet performance standards for financial accuracy, processing accuracy and claim timeliness
• Respond to insured inquiries regarding specific claim details via telephone conversations and/or written correspondence
• Gather and analyze information skillfully to identify and resolve problems in a timely manner

Knowledge/Skills/Competencies Required:

• New hires should live a commutable distance from the site the role is posted in.
• Excellent analytical and mathematical skills
• Ability to pay attention to detail
• Ability to comprehend and apply varied rules to multiple policies
• Works well in a team environment
• Excellent organizational skills
• Proven ability to meet quality and time standards
• Basic knowledge of computer system, Microsoft Word, and Excel

• New hires should live a commutable distance from the site the role is posted in.

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.

MetLife:

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 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 $642.4 billion of total assets under management as of March 31, 2021. We are ranked #46 on the Fortune 500 list for 2021. In 2020, we were named to the Dow Jones Sustainability Index (DJSI) for the fifth year in a row. DJSI is a global index to track the leading sustainability-driven companies. We are proud to have been named to Fortune magazine’s 2021 list of the “World’s Most Admired 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.

Requisition #: 126777