Claims Approver - LTC

  • Company: MetLife
  • Location: Tampa, Florida
  • Posted: February 23, 2017
  • Reference ID: 44581-en_US

Job Location: United States : Florida : Tampa  



Highly specialized job function that is responsible for claim analysis and claim processing for long term care services. 



This position is accountable for reviewing claims for accuracy, timeliness, completeness and eligibility for multiple groups with varied benefits.



  • Analyze and process claims in a productive environment through our TLC claim system
  • Appropriately interpret a variety of plan provisions and process claims accordingly, calculating claim payments and overpayments
  • Review claims for receipt of all needed documentation and make outbound calls to providers for additional information
  • Collaborate with our Claim Support Specialists, Customer Call Center and Care Coordinators to provide a seamless claims experience
  • Abide by department guidelines and appropriately follow up on necessary tasks to process claims
  • Meet quality review standards of processed claims
  • Meet performance standards for financial accuracy, processing accuracy and claim timeliness
  • Respond to insured inquiries regarding specific claim details via telephone conversations and/or written correspondence
  • Gather and analyze information skillfully to identify and resolve problems in a timely manner
  • At least 2 years experience in a claim environment preferred
  • Associate level or higher degree preferred


Global Technology & Operations



“At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers.” 



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.

For immediate consideration, click the Apply Now button. You will be directed to complete an on-line profile. Upon completion, you will receive an automated confirmation email verifying you have successfully applied to the job.

Requisition #: 44581 

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