Job Description

CountryIndiaWorking ScheduleFull-TimeWork ArrangementHybridRelocation Assistance AvailableNoPosted Date23-Jul-2024Job ID3652Description and Requirements -Position TitlePremium Waiver Claims AssistantFunction, Responsibility LevelOperations, ExecutiveReports toAssistant ManagerSupervises - # of FTEs\'Associate NameSpan of ControlNoneLocation - MetLife GOSC (MCC Noida)Business TypeBusiness ComplexityT3C3Basic FunctionResponsible for the review and analysis of Bridged Claims when LTD claim is approved, or denied. Supports the Life Waiver team by processing any and all pre clams generated by the decision on the existing LTD claim. Identifies and determines appropriate pre claims to send the shortened bridge form to the appropriate day to day contact for the completion of the bridge form. If no response is received follow up requests are sent in addition to potentially engaging support staff internal with MetLife to assist in obtain the form.

• Responsible for managing the New Claim queue. Claims will be created in BIOS the Life Waiver claim system, and routing the new claim to the appropriate work queue in Netview based on the special handle customer list.

• Responsible for managing the Returned mail queue. Responsible for the review and research of any returned mail received to identify a current address and take the appropriate action to resend the correspondence.

• Responsible for managing the Unidentified mail queue. Responsible for review and research of any unidentified mail received to identify the appropriate claim and/or queue the document needs to be routed to.

Essential Functions

• Research and process transactions as per Desktop procedures
• Research & investigate and resolve outstanding items
• Determine eligibility and applicable plan provisions while meeting timeliness goals
• Utilize Intellis, DPA, BIOS, NetView, ACS (SIR) to update and maintain accurate data record
• Use PC programs to increase productivity and performance
• 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
• Sedentary work - involves sitting most of the time
• Close visual acuity - viewing a computer terminal and extensive reading
• Talking - expressing or exchanging ideas by means of the spoken word

Any other essential function that may occur from time to time as directed by the SupervisorPrimary Internal Interactions

• AM for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support.

• Manager for the purpose of settling issues left unresolved by the AM and monthly evaluation of performance.

• Subject Matter Expert for the purpose of work thread related issues and escalated transactions.

• QCA for the purpose of feedback and audit

• Trainers for the purpose of Pre-process and Process training

Primary External Interactions

• No external interactions

Pre-requisiteEducational Qualification

• Bachelor\'s degree (Any Stream) or diploma with a minimum of 15 years of education.

( Candidates with B.Tech, MBA, BCA, or with any technical education would not be required)Work Experience Requirements:ExperiencedMinimum 1-2 years of experience in a transactional, process of insurance or related industry with relevant experience of working in a business environment (preferred but not compulsory)Fresher\'sTechnical Skills

• Good computer navigation skills

• Good keyboarding speed

• Good knowledge of complete MS Office suite

Process Specific Skills

• Knowledge about the Insurance industry in US

• Knowledge about US Culture

• Knowledge of Insurance principles

Pre-requisite skill setsAssociateKnowledgeTrainerAssistantManagerEducation -College (Graduation). For specific qualification, please specify.XSpecialized Skill-sets Required - Please specifyOMinimum Work Experience (Years)Up to 1 year of work experience in Data EntrySkills-Customer ServiceOSkills-Problem Solving/Analytical AbilityXJudgment and Decision MakingXSkills-Handle Multiple Task/Time Mgt.XSkills-English reading and writingXSkills-English spokenOKeyboard AccuracyXEye for detailXPeople Management skillsNAPerformance Management skillsNAX - RequiredO - OptionalNA - Not ApplicableAcknowledgement (acknowledge that the information contained in this document is factual and complete)Garima Srivastava/Pankaj BhayanaSupervisor/Manager DateMetLife Values :Core Values:The employee should adhere to MetLife Core values:People Count - It\'s all about people\xe2\x80\xa6 MetLife\'s key resource. MetLife will succeed in the marketplace because we are winning from within.Integrity and Honesty - Conducting our business endeavors with truth, sincerity and fairness.Innovation - Continuously creating and introducing new and original ideas and ways of doing things.Financial Strength - Operating with an intense dedication to managing monetary resources for strong business results.Partnership - Functioning productively in teams towards a common purpose-realizing the collective power of diverse work groups.Personal Responsibility - "Coming into your own"-performing as a leader to be really effective and successful-by acting and making decisions independently to get results.

MetLife