Sr Insurance Associate

Job Description

• 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
• Good understanding of Claims adjudication fundamentals 
• Good 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

Technical Skills

• Computer navigation skills
• Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
• Working knowledge of MS Excel and MS Word.
• Process Specific Skills
• Knowledge of Insurance principles in relation to the US Insurance industry
• Knowledge about US Culture
• Knowledge of Dental claims terminologies and processes will be an added advantage 
• Written- External/Internal (Free Flow) Email Writing 
• Free flow correspondence creation
• Excellent comprehension skills – Interpret/analyze data from various resources , understands , documents and responds  appropriately

Soft Skills

• Strong organizational skills
• Excellent Language skills (written ,verbal and comprehension)
• Demonstrate ability to work independently and in a team environment
• Self-disciplined and results oriented
• Ability to multi task
• Strong understanding and comprehension of the English language
• Good PC skills
• Attention to detail
• Team player
• Positive attitude