Sr. Claims Specialist Provider Verification

  • Company: MetLife
  • Location: Tampa, Florida
  • Posted: March 29, 2017
  • Reference ID: 50882-en_US

Job Location: United States : Florida : Tampa  



This role provides administration of benefits and obtains information for Long-Term Care Insurance.   Administration includes provider verification, research, and customer service.




  • Provider Verification: Research providers to see if they meet requirements rules vary depending on state and policy provisions.
  • Provider Verification Expiration Report- update providers license/credentials that we are currently paying claims.
  • Research what providers are available to our insured’s based on their area of residence.
  • Provides claim information, assists with submission of claims and makes outbound calls to gather missing information on incomplete claims. 
  • Conducts research when needed to resolve customer questions or complaints. 
  • Update our administrative system.
  • Understands processes in entire department to assist callers with questions. 
  • Works closely with the claim analysts and care managers to provide a seamless customer experience. 
  • Outbound calls and letters to customers and providers to research incomplete claims.  Escalates complaints and potential complaints appropriately. 
  • Documents calls in computer system. 
  • Completes form letters, tasks and problem solve for resolution of customer issues.  Contributes ideas that enhance service quality. 
  • Performs project work and other related duties as assigned or required.



  • 2+ years direct customer service experience.
  • Excellent communication skills (verbal and written).
  • Ability to work efficiently in a fast-paced environment.
  • College degree preferred.
  • Ability to use Microsoft Office .



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.

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Requisition #: 50882 

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