Scrutinizing dental claim documents & settlements
Process claims as per the set healthcare guidelines
Respond to customer requests via multiple sources, providing excellent service to MetLife’s customers who have insurance or other financial service products or benefit plans.
Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.
Follow HIPAA guidelines
Accurate processing of Dental claims and meeting productivity targets
Positive understanding of Claims adjudication fundamentals
Valuable understanding of ICT & CPT Codes
Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer’s inquiry.
Handle escalations
Need to ensure quality and productivity targets are met
Ensure compliance with internal policies and procedures, external regulations and information security standards

📌 Sr Insurance Associate Noida (India)
🏢 MetLife
📍 India