Sr. Insurance Associate

Job description

Description and Requirements Associates will be responsible for reviewing and evaluating Long Team Disability and Short Term Disability claims to determine MetLife’s liability by giving consideration to contract provisions, medical and vocational evidence. Associates will contact Business SME’s where needed; update and maintain accurate data records.

Essential Functions

• Analyze, validate and process transactions as per Desktop procedures (L3 & L4).
• Analyze and research all discrepancies.
• Investigate and resolve outstanding items
• Determine eligibility and applicable plan provisions while meeting timeliness goals
• Clear and accurate written and verbal communication
• Establish action plans for each file to bring claims to resolution
• Utilize Intellis and ACS (SIR) to update and maintain accurate data record
• Ensure that the assigned targets are met in accordance with SLA and Internal standards.
• Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence.
• Work as a team member to meet office goals to obtain disability’s vision while demonstrating core values and meeting key measures.
• Ensure adherence to established attendance schedules.

AI Fluency

Working Knowledge of Microsoft Copilot Any other essential function that may occur from time to time as directed by the Supervisor.