Sr Insurance Associate

MetLife; Dadri; On-site; INR 300,000 - 500,000; Full time

Job summary

MetLife India is seeking a claims processor to handle dental claim documents and settlements. The role focuses on accurate processing, adherence to healthcare guidelines, and responding to customer inquiries across multiple channels.

The candidate should have strong data entry speed, proficiency in MS Excel/Word, and a solid understanding of US insurance concepts. Knowledge of HIPAA and regulatory requirements is essential.

Qualifications

• Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy).
• Working knowledge of MS Excel and MS Word.
• Knowledge of Insurance principles in relation to the US Insurance industry.
• Knowledge about US Culture.
• Written correspondence and email writing ability.

Responsibilities

• Scrutinizing dental claim documents and settlements.
• Process claims per healthcare guidelines and productivity targets.
• Respond to customer requests via multiple sources with excellent service.
• Research requests regarding product aspects, policy provisions and claim status.
• Follow HIPAA guidelines and ensure compliance with policies and security standards.
• Handle escalations and maintain quality of service.

Skills

Computer navigation

Data entry speed

MS Excel

MS Word

Insurance principles

US culture

Dental claims terminology

Written emails

Free flow correspondence

Analytical skills

Attention to detail

Team collaboration

English language proficiency

Tools

MS Excel

MS Word

Job description

• Process claims as per the set healthcare guidelines
• Respond to customer requests via multiple sources, providing excellent service to MetLife’s customers who have insurance or other financial service products or benefit plans.
• Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.
• Follow HIPAA guidelines
• Accurate processing of Dental claims and meeting productivity targets
• Good understanding of Claims adjudication fundamentals
• Good understanding of ICT & CPT Codes
• Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
• Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
• Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer’s inquiry.
• Need to ensure quality and productivity targets are met
• Ensure compliance with internal policies and procedures, external regulations and information security standards

Job Responsibilities

• Scrutinizing dental claim documents & settlements
• Process claims as per the set healthcare guidelines
• Respond to customer requests via multiple sources, providing excellent service to MetLife’s customers who have insurance or other financial service products or benefit plans.
• Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.
• Follow HIPAA guidelines
• Accurate processing of Dental claims and meeting productivity targets
• Good understanding of Claims adjudication fundamentals
• Good understanding of ICT & CPT Codes
• Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
• Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
• Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer’s inquiry.
• Handle escalations
• Need to ensure quality and productivity targets are met
• Ensure compliance with internal policies and procedures, external regulations and information security standards

Technical Skills

• Computer navigation skills
• Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
• Working knowledge of MS Excel and MS Word.
• Process Specific Skills
• Knowledge of Insurance principles in relation to the US Insurance industry
• Knowledge about US Culture
• Knowledge of Dental claims terminologies and processes will be an added advantage
• Written- External/Internal (Free Flow) Email Writing
• Free flow correspondence creation
• Excellent comprehension skills – Interpret/analyze data from various resources , understands , documents and responds appropriately

Soft Skills

• Strong organizational skills
• Excellent Language skills (written ,verbal and comprehension)
• Demonstrate ability to work independently and in a team environment
• Self-disciplined and results oriented
• Ability to multi task
• Strong understanding and comprehension of the English language
• Good PC skills
• Attention to detail
• Team player
• Positive attitude