Senior Insurance Associate - #956792


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


Reports to

Unit Manager / Manager

Approved By:

Span of Control


Location - MetLife GOSC

Permanent/ Temporary


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:


  • 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.


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


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:


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

Organizational Relationships

Reports To: Unit Manager / Manager Supervises: 0


Technical Skills

  • Good computer navigation skills
  • Good keyboarding speed
  • Excellent knowledge of complete Ms Office suite

Process Specific Skills

  • Knowledge about the Insurance industry in US
  • Knowledge about US Culture
  • Knowledge of Insurance principles.
  • End to end product knowledge on Dental required

Soft skills (Minimum)

  • Proficiency in English language both written & verbal skills
  • Excellent Communication skills - should be able to read, interpret business documents.
  • Analytical and interpersonal skills
  • Data gathering ability/ Eye for detail
  • Team work/ Managing Self / Adaptability
  • Highly organized with ability to work independently
  • Prioritize work to meet changing business needs, timelines, goals and metrics. (Project management skills)
  • Adaptability to change

Soft Skills (Desired)

  • Self disciplined and result oriented
  • Ability to multi task
  • Familiarity with Dental Terminology

Education Requirements

  • Bachelor's degree (Any Stream) or diploma with a minimum of 15 years of education.(Candidates with B.Tech, MBA, BCA, or with any technical education would not be required)

Work Experience Requirements

3 - 5 years of experience in Dental claims management & process documentation.


Acknowledgement (acknowledge that the information contained in this document is factual and complete)


Candidate Manager Date

MetLife Values :

Core Values:

The employee should adhere to MetLife Core values:

People Count - It's all about people MetLife's key resource. MetLife will succeed in the marketplace because we are winning from within.

Integrity and Honesty - Conducting our business endeavors with truth, sincerity and fairness.

Innovation - Continuously creating and introducing new and original ideas and ways of doing things.

Financial Strength - Operating with an intense dedication to managing monetary resources for strong business results.

Partnership - Functioning productively in teams towards a common purpose-realizing the collective power of diverse work groups.

Personal Responsibility - Coming into your own-performing as a leader to be really effective and successful-by acting and making decisions independently to get results.

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