Senior Insurance Associate

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Date Posted: Apr 30, 2024

Location(s): Jaipur, IN

Company: MetLife

Job Description – Dental Business Procedure Consultant

 

Position Title

Dental business procedures

Function, Responsibility Level

Operations

Reports to

Unit Manager / Manager

Approved By:

 

 

Span of Control

0                              

Location - MetLife GOSC

 

Permanent/ Temporary

Permanent

 

Basic Function

  • To manage dental business procedures of Dental claims in partnership with stateside
  • This role will document new or revise guidelines for process, procedures and initiatives to support dental claim operations in all areas of claim management.

 

Essential Functions

 

  • Documents all standard and non-standard Dental process guidelines and correspondence within the Group Dental Product. Able to document business requirements into efficient process steps and actions for the development of guidelines. 
  • Assist with the management, processing and documentation of customer variances from a process and correspondence perspective.
  • Ensure that requested updates are handled timely and accurately and meeting our customer needs while remaining within all compliance and regulatory requirements.
  • Review, investigate and respond to questions related to individual change requests. Identify gaps in content and/or inefficiencies in proposed process and recommend alternative solutions.
  • Work with multiple partners for investigation, analysis, and development of nonstandard process and/or correspondence requests including but not limited to claim operations, customer delivery and legal. Works with all parties to ensure agreement and sign off on final outcome. 
  • May communicate information to requestors and other business partners to help resolve inquiries related to a requested change for process and/or correspondence. 
  • Performs other duties as assigned or required

 

 

Any other essential function that may occur from time to time as directed.

 

Primary Internal Interactions

 

  • Unit Manager / Manager for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support.
  • Unit Manager / Manager for the purpose of settling issues left unresolved and monthly evaluation of performance.
  • Stateside Auditors for the purpose of seeking cooperation & clarification on process-related matters & providing assistance and support when required.
  • Subject Matter Expert for the purpose of work thread related issues and escalated transactions.
  • Trainers for the purpose of Pre-process and Process training.

 

Primary External Interactions

 

 

  • Stateside process owner for business discussion.

 

Essential Business Experience and Technical Skills:

 

Required:

 

  • 3-5 years of Group Life or Group Dental claims management experience. Expert knowledge/experience level of varied process/products, Federal and State regulations, claim management and correspondence systems. 
  • Excellent verbal & written communication skills/ content writing skills
  • Highly organized; able to work independently and prioritize work to meet changing business needs, timelines, goals and metrics.
  • Demonstrated leadership skills and self-direction a must.
  • Demonstrated ability to manage multiple, completing priorities.

 

Preferred

  • Able to work with various company databases (SharePoint, Livelink), Webex and Microsoft program suite (Word, Excel).

 

Pre-requisite

 

Educational Qualification

 

  • Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.
  • Excellent verbal & written communication skills
  • Proficient in usage of MS Office suite

 

Work Experience Requirements:

 

Experienced:

 

3 - 5 years of experience in Dental claims adjudication

 

 

 

Technical Skills

· Computer navigation skills

· Keyboarding and data entry speed (minimum 30 wpm with 90%  accuracy)

· Proficiency in MS Office suite.

Process Specific Skills

· Excellent written & verbal communication skills

· Strong understanding and comprehension of the English language

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Organizational Relationships

 

Reports To: Unit Manager / Manager                                                                                          Supervises: 0

 

Skills

Technical Skills

 

  • Good computer navigation skills
  • Good keyboarding speed
  • Excellent knowledge of complete Ms Office suite

 

 

Process Specific Skills

 

  • Knowledge about the Insurance industry in US
  • Knowledge about US Culture
  • Knowledge of Insurance principles.
  • End to end product knowledge on Dental required

 

 

Soft skills (Minimum)

 

  • Proficiency in English language both written & verbal skills
  • Excellent Communication skills – should be able to read, interpret business documents.
  • Analytical and interpersonal skills
  • Data gathering ability/ Eye for detail
  • Team work/ Managing Self / Adaptability
  • Highly organized with ability to work independently
  • Prioritize work to meet changing business needs, timelines, goals and metrics. (Project management skills)
  • Adaptability to change

Soft Skills (Desired)

 

  • Self disciplined and result oriented
  • Ability to multi task
  • Familiarity with Dental Terminology

 

Education Requirements

 

  • Bachelor’s degree (Any Stream) or diploma with a minimum of 15 years of education.(Candidates with B.Tech, MBA, BCA, or with any technical education would not be required)

 

 

Work Experience Requirements

 

3 – 5 years of experience in Dental claims management & process documentation.   

 

 

 

 

 

Enclosures:

 

 

Acknowledgement (acknowledge that the information contained in this document is factual and complete)

 

___________________________________                          

        

 Candidate                                                                             Manager                               Date

MetLife Values :

 

Core Values:

 

The employee should adhere to MetLife Core values:

 

People Count - It's all about people… MetLife's key resource.  MetLife will succeed in the marketplace because we are winning from within.

Integrity and Honesty - Conducting our business endeavors with truth, sincerity and fairness.

Innovation - Continuously creating and introducing new and original ideas and ways of doing things.

Financial Strength - Operating with an intense dedication to managing monetary resources for strong business results.

Partnership - Functioning productively in teams towards a common purpose-realizing the collective power of diverse work groups.

Personal Responsibility - "Coming into your own"-performing as a leader to be really effective and successful-by acting and making decisions independently to get results.

 

 

MetLife:

 

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 help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.

 

We are ranked #44 on the Fortune 500 list for 2019. In 2019, we were named to the Dow Jones Sustainability Index (DJSI) for the fourth year in a row. DJSI is a global index to track the leading sustainability-driven companies.      

 

MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.

 

MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to 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.

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