Specialist
- Metlife
- 2 - 10 years
- Noida, Gurugram
- 15 days ago
- Email to a friend
- Report this job
Job Description
General Information
Location Noida, Uttar Pradesh Working Schedule Full-Time Work Arrangement Hybrid Relocation Assistance Available No Description and RequirementsHandle and administer Family Medical Leave Act standalone (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures
Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee or employer through outgoing calls, email or other supporting systems.
Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans and make initial claim decision.
Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, return phone calls, etc .
Update systems to accurately reflect leave status and ensure appropriate diary documentation exists
Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures
The position is expected to do absence management and adjudication on Federal, State and company leaves.
Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician s office
Essential Functions
- Analyze, validate and process transactions as per Desktop procedures (L3 L4 )
- Analyze and research all discrepancies
- Research Investigate and resolve outstanding items
- Determine eligibility , entitlement and applicable plan provisions while meeting timeliness goals
- Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer stateside resources by email and outgoing calls
- Establish action plans for each file to bring claims to resolution
- Utilize internal and external specialty resources to maximize impact on each claim file
- Use PC programs to increase productivity and performance
- Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee 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
- Close visual activity - viewing a computer terminal and extensive reading
- Any other essential function that may occur from time to time as directed by the Supervisor.
Job Classification
Industry: InsuranceFunctional Area / Department: Customer Success, Service & OperationsRole Category: Non VoiceRole: Technical Support - Non VoiceEmployement Type: Full timeContact Details:
Company: MetlifeLocation(s): Noida, Gurugram
Keyskills: Supervisor Usage Claims Compliance Process excellence Workflow Research Management
Similar positions
Metlife
PNB MetLife India Insurance Company Limited (PNB MetLife) is one of the leading life insurance companies in India. PNB MetLife has as its shareholders MetLife International Holdings LLC (MIHL), Punjab National Bank Limited (PNB), Jammu & Kashmir Bank Limited (JKB), M. Pallonji and Company Privat...
Job Listings
We are in open beta version of website, please let us know if any issues, at: info(at)indigojobs.in