Specialist

Metlife

5 - 10 years

7 - 12 Lacs

noida

Posted:1 day ago| Platform:

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Skills Required

insurance communication skills written data validation health insurance us healthcare presentation skills claims adjudication research healthcare claims processing excel operations underwriting writing claims general insurance communication skills

Work Mode

Work from Office

Job Type

Full Time

Job Description

Analyze, validate, and process transactions as per Desktop procedures (L3 L4)
Analyze and research all discrepancies.
Research investigate and resolve outstanding items
Determine eligibility and applicable plan provisions while meeting timeliness goals
Clear and accurate written and verbal communication (Scripted and Templatized) with employee,
employer stateside resources by email
Establish action plans for each file to bring claims to resolution
Utilize internal and external specialty resources to maximize impact on each claim file
Utilize Intellis and 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

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