Senior Insurance Associate - #956570

metlife


Date: 1 week ago
City: Jaipur, Rajasthan
Contract type: Full time
Job Description – Dental Business Procedure Consultant

Position Title

Dental business procedures

Function, Responsibility Level

Operations

Reports to

Unit Manager / Manager

Approved By:

Span of Control

0

Location - MetLife GOSC
Permanent/ Temporary Permanent
Basic Function
  • To manage dental business procedures of Dental claims in partnership with stateside
  • This role will document new or revise guidelines for process, procedures and initiatives to support dental claim operations in all areas of claim management.

Essential Functions
  • Documents all standard and non-standard Dental process guidelines and correspondence within the Group Dental Product. Able to document business requirements into efficient process steps and actions for the development of guidelines.
  • Assist with the management, processing and documentation of customer variances from a process and correspondence perspective.
  • Ensure that requested updates are handled timely and accurately and meeting our customer needs while remaining within all compliance and regulatory requirements.
  • Review, investigate and respond to questions related to individual change requests. Identify gaps in content and/or inefficiencies in proposed process and recommend alternative solutions.
  • Work with multiple partners for investigation, analysis, and development of nonstandard process and/or correspondence requests including but not limited to claim operations, customer delivery and legal. Works with all parties to ensure agreement and sign off on final outcome.
  • May communicate information to requestors and other business partners to help resolve inquiries related to a requested change for process and/or correspondence.
  • Performs other duties as assigned or required

Any other essential function that may occur from time to time as directed.

Primary Internal Interactions

  • Unit Manager / Manager for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support.
  • Unit Manager / Manager for the purpose of settling issues left unresolved and monthly evaluation of performance.
  • Stateside Auditors for the purpose of seeking cooperation & clarification on process-related matters & providing assistance and support when required.
  • Subject Matter Expert for the purpose of work thread related issues and escalated transactions.
  • Trainers for the purpose of Pre-process and Process training.

Primary External Interactions
  • Stateside process owner for business discussion.

Essential Business Experience and Technical Skills:

Required:

  • 3-5 years of Group Life or Group Dental claims management experience. Expert knowledge/experience level of varied process/products, Federal and State regulations, claim management and correspondence systems.
  • Excellent verbal & written communication skills/ content writing skills
  • Highly organized; able to work independently and prioritize work to meet changing business needs, timelines, goals and metrics.
  • Demonstrated leadership skills and self-direction a must.
  • Demonstrated ability to manage multiple, completing priorities.

Preferred

  • Able to work with various company databases (SharePoint, Livelink), Webex and Microsoft program suite (Word, Excel).
Pre-requisite

Educational Qualification

  • Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.
  • Excellent verbal & written communication skills
  • Proficient in usage of MS Office suite

Work Experience Requirements:

Experienced:

3 - 5 years of experience in Dental claims adjudication

Technical Skills

· Computer navigation skills

· Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)

· Proficiency in MS Office suite.

Process Specific Skills

· Excellent written & verbal communication skills

· Strong understanding and comprehension of the English language

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