General Information

Location

Noida, Uttar Pradesh

Working Schedule

Full-Time

Work Arrangement

Hybrid

Relocation Assistance Available

No

Posted Date

11-Aug-2026

Job ID

19733

Description and Requirements

Position Summary

The Specialist/Provider Control Unit Reviewers would require assessing the reason for Claim adjudication failure. Follow the documentation to research various MetLife databases / systems or call relevant parties to seek the correct information. The Job of the Reviewer is to rectify and correct the information for a seamless Claims processing. This will require the Reviewer to gather the information from Metlife application and calling the providers/ providers office etc. The calls in scope are B2B calls

Job Responsibilities

- Interacts with multiple internal and external partners
- Corresponds with providers, providers office, to gather necessary information, clarify details to ensure correctness of the records in various reference systems for Claims processing
- Respond to incoming calls from providers & make outbound calls to providers / provider office /dentists
- Create, update, and maintain provider records in internal systems
- Conduct research in multiple systems to resolve the discrepancies in provider information (submitted Claims vs referral systems)
- Utilizes multiple mainframes, PC, and Internet based systems
- Validate/ update provider information (billing and rendering) for accuracy, completeness and eligibility according to established guidelines to support claim processing




- Efficiently update system logs basis the call / action taken
- Efficiently access and navigate multiple applications to gather and assess information
- Efficiently coordinate with process associates in prescribed scenarios i.e.
- Any other essential function that may occur from time to time as directed by the Supervisor
- Perform these responsibilities in a consistent, professional manner while exercising strong verbal, written, and high-quality service skills

Essential Functions:

- Semi scripted calling (outbound 50% & ~10% inbound calls) should be fluent in speaking & writing English
- Ability to interact & connect with Provider over a call
- Excellent comprehension skills – Interpret/analyze information from various resources, problem solving and responds appropriately
- Computer navigation skills, multiple application
- Should be comfortable working on 2 to 3 computer screens
- Ability to research & take decision to resolve problem
- Analytical and eye to details to find discrepancy in the information
- Prefer to have knowledge of Insurance principles in relation to the US Insurance industry
- Knowledge about US Culture. Strong organizational skills




- Demonstrate ability to work independently and in a team environment
- Self-disciplined and results oriented, ability to multitask
- Must be open to work in rotational shifts X 5 days work from office

About MetLife

Recognized on Fortune magazine's list of the "World's Most Admired Companies" and Fortune World’s 25 Best Workplaces™, MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies; providing insurance, annuities, employee perks and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

As part of our New Frontier strategy, MetLife is building an AI-enabled, people-centered future. We’re looking for people who bring curiosity, adaptability, and a growth mindset as we use AI to enhance how we serve customers, support communities, and evolve the way work gets done. At MetLife, AI is a responsible partner that supports human judgment, creativity, and continuous improvement while helping us build trust, inclusion, and long-term value.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we’re inspired to transform the next century in financial services. At MetLife, it’s #AllTogetherPossible. Join us!

📌 Specialist (India)
🏢 MetLife
📍 India