Job Title
Location : Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR, West Des Moines, IA office Once a month in office for meetings
Key Responsibilities
Partners with the STD Unit Leader to analyze and identify barriers for the success and efficiency of their team. Supports and guides assigned team member to ensure that they have the knowledge and skills, tools, and resources to be successful in achieving those expectations by delivering on commitments, timely return of phone calls, clear communication, accuracy of decisions and financial accuracy
Drives Claim Management Accuracy and Customer Centricity through support of the Pre-QA Program, claim file reviews and call monitoring auditing claim file reviews to identify improvement opportunities, skillset gaps, trends for quality, service and / or compliance
Accountable for reviews and approves key decisions made by team member(s) within authority limit including financial accuracy of coding Claims System including accurate claim Benefit Amount / Salary and appropriately investigates other income / offsets in accordance with Customer's plan / policy
Managing operation efficiency goals and provides positive reinforcement to team members that is directly linked to their behaviors and performance objectives and maintains data integrity. Performs other related duties as assigned or required
Essential Business Experience and Technical Skills
Required : A comprehensive understanding of the disability contractual provisions, especially the definition of disability. Ability to coach and mentor members of the team Strong communication skills, including the ability to interview claimants dynamically with the goal of setting claimant expectations and obtaining information necessary to administer the claim. Basic knowledge of medical conditions, treatments, prognosis Critical-thinking skills Ability to give and receive feedback to / from partners Strategic-thinking skills and the ability to apply judgment and decision-making based on strategy Prioritization skills. Ability to balance quantity and quality. Ability to partner with Internal / External Customers
High School Diploma Preferred : Associate Degree 2 plus years of claims management experience preferably in Healthcare field 5 plus years of Management Proficient in Microsoft Word / Excel
Key Competencies, Qualifications and Skills, Preferred
Equal Employment Opportunity / Disability / Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process. MetLife maintains a drug-free workplace.
Support Specialist • Omaha, NE, US