Business Procedures Consultant

Responsible for conducting timely reviews and analysis of adverse benefit determinations on claim files received on appeal and rendering a final determination in accordance with ERISA laws and regulations. Responsible for creating and monitoring metrics reports, and completing monthly reserve file reconciliation.  General projects as requested by manager (primarily reserving issues).  Serves as backup unit manager.

 

Knowledge/Skills/Competencies Required:
Indepth knowledge of contract provisions and claims workflow process
Minimum 3 years of LTD claims management experience
Knowledge of ERISA
Ability to work collaboratively and build relationships
Demonstrates flexibility and the ability to adapt to change
Solid analytical and interpretive skills
Excellent listening and interpersonal skills
Ability to communicate clearly, logically, and diplomatically, both verbally and in writing
Demonstrates sound business judgement in final claim determination, with clear documentation to support decision
Ability to prioritize multiple tasks
Strong customer service orientation
Ability to work independently with minimal supervision as well as collaboratively with others
PC skills in Microsoft and various software programs
MetLife is an Equal Opportunity Employer.

Additional?Information

Salary:?43,800.00 - 53,600.00 USD /year
Position?Type:?Full Time, Employee
Number of Openings:?1
Travel paid for interviews??NO
Relocation expenses paid??NO
Percent of travel on the job:?5-15%%
Company Code:?Metropolitan Life Insurance Co.