Claims Adjuster - No Fault Medical Payment

  • Company: MetLife
  • Posted: April 26, 2017
  • Reference ID: 52341-en_US

Position Location:

St. Louis FCO or Troy, NY FCO


Job Summary: 

Provides exceptional customer service while investigating, evaluating and resolving No Fault – Med Pay claims. 

Functional Responsibilities

  • Communicates with insured’s, claimants and other parties to determine the facts of the claim. 
  • Documents claims file to comply with company guidelines and state regulations. 
  • Reviews factual information to determine coverage of all parties to the claim. 
  • Performs medical bill audit, analysis and reviews medical records
  • Resolves complaints, and participates in arbitration and/or grievance procedures. 
  • Recommends subrogation and/or SIU referral. 
  • Manages pending claims to meet company quality criteria. 
  • Performs other related duties as assigned or required.
  • Ability to work within a team environment which requires strong communication skills.

Supervisory Responsibilities:  None.

Basic Qualifications: 

  • High School Diploma/GED. 
  • 2-3+ yrs. related business experience.

Preferred  Qualifications:

  • Bachelor’s Degree
  • Insurance Experience
  • Claims Experience
  • Excellent verbal and written communication skills
  • Strong Computer skills
  • Medical background
  • Detail oriented and accurate 



MetLife is a proud equal opportunity/affirmative action employer committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. It is MetLife's policy to ensure equal employment opportunity without discrimination or harassment based on race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

MetLife maintains a drug-free workplace.

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