MetLife Employment – Case Management Specialist

Website MetLife

Job Description:

Review, research, and investigate pended FEGLI Life claim submission with multiple coverages and complexity to determine if claim is payable in accordance with various policy provisions. If payable, determine eligible payee(s) and payment amount(s). If not payable, develop detailed letter of explanation based on policy provisions and claim documents. Provides customer service with empathy and patience on incoming and outgoing phone inquiries and provides guidance on life claim processes.

Job Responsibilities:

  • Maintain good rapport with internal and external customers by taking ownership and projecting an attitude of service.
  • Handle customer escalations from Customer Service Associates and solve customer problems via telephone using sound business judgment.
  • Interpret policy provisions and manually adjudicate FEGLI Life claims to make claim determinations.
  • Respond to written inquiries from policyholders, beneficiaries, attorneys and families of deceased employees. Provide guidance on claim processes and resolve customer issues swiftly and thoroughly.
  • Provide high quality, timely service to policyholders, beneficiaries, attorneys, families of deceased employees and administration; resolve customer issues swiftly and thoroughly by offering recommendations and solutions.
  • Work with our customer administrative staff to clarify plan provisions and resolve claim discrepancies.
  • Actively pursue and follow up on open claims within specified timeframe.
  • Use Microsoft Word and Excel to obtain information required to evaluate the life claim.
  • Maintain production and quality standards.
  • Evaluate life claims to identify claim situations requiring referral to Complex Case Manager Specialist or Claims Quality Specialist.
  • Keep up to date on FEGLI Life procedures by using the Livelink system and attending required training.
  • Identify and obtain missing information required to evaluate FEGLI life claims and input information into a Power Builder computer claim system computer system
  • Handle outbound calls needed in regards to FEGLI Life servicing.
  • Manage and organize work to meet multiple deadlines and competing priorities to ensure department turnaround and customer satisfaction are met.

Job Requirements:

  • Desire, willingness and ability to learn and perform in a fast-paced environment.
  • Life insurance experience highly desirable.
  • PC knowledge required. (Microsoft Word and Excel)
  • Ability to work periodic overtime required; can include weekends.
  • Demonstrated outstanding customer service and communication skills both written and verbal.
  • Strong data entry skills required.
  • Excellent oral and written communication skills.
  • College degree or relevant job experience desirable.
  • Ability to adjust to multiple demands and shifting priorities.
  • Confidentiality required.
  • Analytical ability and good judgment in evaluating life claim submissions.
  • Ability to deal with people in stressful situations.

Job Details:

Company:  MetLife

Vacancy Type:  Full Time

Job Location: Utica, NY, US

Application Deadline: N/A

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