Claims Examiner

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 Claims Examiner implements the Company’s established standards and procedures in examining and resolving medical claims whilst maintaining high-quality customer service and ensuring legal compliance. The claims team consists of 5 team players, with strong communication and collaboration. Shared goals and objectives are focused on team colleagues supporting each other and giving their maximum effort to achieve a common goal and achieve the workflow effectively and efficiently.

Key Responsibilities

Process and review Individual and Group claim cases as per the written terms and conditions of the policies, in a timely and accurate manner Determine the validity of the claim and communicate with internal departments to review the terms of the Policy; Ensure completeness and accuracy of claim documentation and contact claimants directly to request any missing information or verification; Liaise with medical and state institutions in order to collect additional information and/or evidence; Contact medical advisors for expert claim evaluation where necessary; Maintain the claim database and ensure required documentation is accurately collected and properly filed; Maintain appropriate written records from treating physicians, legal advisors and other experts regarding the claims; Inform supervisor of any suspicions for fraud or misrepresentation of facts; Perform final claim assessment and settle the claims with payment or rejection; Authorize claim payments; Follow communication guidelines for informing claimant of decisions; Set and adjust the claim reserves; Prepare and submit reports related to claims; Effectively handle customer inquiries, with the aim of achieving the highest standards of customer satisfaction; Ensure all claims information remains confidential; Identify areas of improvement and make appropriate suggestions; Ability to use approved AI tools to support routine tasks such as drafting, summarizing, organizing information, and improving day-to-day efficiency.

Required Qualifications

University educated to degree level, in the health sector or other relevant area e.g. insurance A minimum of 2 years of experience in a similar position, undertaking Health Claims assessing/examining/relevant Health Medical experience, Broad knowledge of medical terminology; Excellent knowledge of MS Office (Excel, World and Outlook); Fluent communicator in

Greek and English, both written and spoken; Proven ability to plan and prioritize work, manage time and respond efficiently to changing circumstances; Team player with effective communication and interpersonal skills; Attention to detail and high-level of accuracy; Customer-orientation; Analytical thinking and problem-solving ability; Resilient personality with the ability to promptly address multiple requests; Working knowledge of AI capabilities with the ability to evaluate and validate outputs with guidance; Preferred

Qualifications Medical/Life Claims assessing/examining The expected salary range for this position is €22,100 - €25,000 per annum .

This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.