Group Life Claim Reviewer - 21213

Job description

Description and Requirements The Team You Will Join On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement. Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide.

Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time. The Opportunity The Claim Reviewer is responsible for providing high quality review and payment of claims, and also provide compassionate service to our beneficiaries and families of deceased employees to assist with the claims process across the country. This is an exciting opportunity to learn the Group Life claims process and potential to further your development, while making a positive impact on our claimants.

Key Responsibilities

Functional Responsibilities:

• Checks Group Life claim documentation or other company forms for completeness and accuracy.
• Evaluate Group Life claim submissions for accuracy to ensure correct claim payment.
• Evaluate Group Life claim submissions to identify situations requiring referral to Claim Examiner.
• Reviews data from various sources, including policyholders; translates it into appropriate media for input into a Windows based computer system (BIOS).
• Respond to written and/or telephone inquiries from policyholders, beneficiaries, attorneys and families of deceased employees.
• Provide guidance to beneficiaries on claim processes and resolve customer issues swiftly and thoroughly.
• Completes all work within turnaround time to meet department and customer objectives.
• Maintain production and quality standards.
• Ensure compliance with state regulations for Group life claims by sending appropriate notifications.
• Perform support functions as needed.
• 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.
• Mentor Reviewers as needed
• Provide compassionate call outs to claimants to assist with the claims process and offer additional services.
• Ai tools used to cross reference library procedures and year end reviews summary

Required Qualifications

New hires should live a commutable distance from the site the role is posted in. Strong communication skills, both written and oral. Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning. Experience with Microsoft Suite (Word, Excel, Teams, etc.) 1+ years Customer Service background with a focus on delivering white glove service to clientele. High School Diploma or GED equivalent.

This role has mandatory paid training

Preferred Qualifications

1+ years’ experience in a call center. Focus on outbound calls preferrable. Prior experience reviewing insurance claims. College Degree or high education. The expected salary range for this position is $41,600 . This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.