Special Investigator - Dental Claims

  • Company: MetLife
  • Location: Oriskany, New York
  • Posted: March 20, 2017
  • Reference ID: 47964-en_US



  • Reviews cases of suspected fraud and/or abuse from various sources, including Claim Department customer, hotline and law enforcement to determine if an investigation is warranted.
  • Formulates action plan with claim specialist; determines need and relevance of various investigative activities, to include, written statements, background and record checks, phone interviews, field investigation and coordination with medical fraud analyst. 
  • Conducts timely and professional investigations to confirm/refute the red flags indicators presented within the referral. 
  • Reports suspected and/or fraudulent claims to applicable state insurance departments.
  • Performs other related duties, including fraud awareness training, as assigned or required.
  • Knowledge of dental claim process and dental procedures is a necessary job requirement.



  • Bachelor's degree.
  • 3-5 yrs. relevant dental claims experience.


P&C Claims




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.

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