Pet Claims Coordinator

Description and Requirements
Job Location: Virtual
Training Schedule: 5 - 6 weeks; Monday - Friday from 8 - 4:30pm EDT
Shift Details: Must work Saturdays and Sundays. Off days will be either Monday & Tuesday OR Thursday & Friday.
8 - 4:30pm EDT
(Discussion will be held during training and team will do their best to accommodate preferences if possible.)
Home State P&C License required within 90 days of hire (supported by MetLife)
Start Date: 12/9/24
Role Value Proposition
The Claims Coordinator accurately reviews medical records and invoices, utilizing their understanding of pet health diagnoses and procedures, to evaluate coverage and equitably settle pet health insurance claims with respect to policy limits & terms. Communicates with the Insured, Veterinarian or Pet Adoption Agency to determine the details of the claim, requesting and verifying necessary documentation, and informs the Insured of claim status or claim outcome. Utilizes the workflow queues to perform job functions to include, claim entry/policy association, pre-adjudication, Insured/Veterinarian documentation requests, claim closeouts, claim appeals, and "good to go" claims processing.
Key Responsibilities
* Requests and communicates with Insureds, Veterinarians, or Adoption Agencies for clarification of diagnosis/additional information necessary to accurately process claim.
* Adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements. Follows adjudication policies and procedures to ensure proper payment of claims.
* Documents phone calls in system and follows up on issues if needed.
* Resolves problems resulting from claim adjudication and communicates claim status and claim outcome with Insureds.
* Prepares reports as required by management and enters/receives inbound documents as assigned.
Essential Business Experience and Technical Skills
Required:
* High school diploma or equivalency
* Three years veterinary medical experience or equivalency preferred. (Vet Tech License Highly preferred)
* Strong understanding of veterinary medical terminology
* Proven history of adherence to corporate policies, procedures, and guidelines
* Proven Attendance Reliability
* Excellent tracking, follow-up, and relationship building skills.
Preferred:
* Ability to operate in a fast-pace, multi-tasking environment with deadlines.
* Strong written, verbal, interpersonal, and phone communication skills
* Articulate, professional, and possesses a strong quality customer service mindset with attention to detail.
* Strong computer background using MS Word, Outlook, Excel, and Internet
* Ability to learn quickly (to include our proprietary CRM system for managing customers)
* Ability to identify problems and logically research with minimum assistance to locate answer through appropriate reference materials.
The salary range for applicants for this position is 41,600.
Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the 2024 "World's Most Admired Companies" as well as the 2024 Fortune 100 Best Companies to Work For ®, MetLife , through its subsidiaries and affiliates, is one of the world's leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by empathy, we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
Equal Employment Opportunity/Disability/Veterans
If you need an accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.
MetLife maintains a drug-free workplace.
41,600