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Claim Reviewer

Date Posted: Jan 11, 2019

Location: Oriskany, NY, US, 13424

Company: MetLife

Job Location: Oriskany, NY


Role Value Proposition: 

Global Operations (Global Ops) focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We’re looking for unique talent with fresh perspectives that can propel innovation. In this role, your primary function will be answering incoming calls from policyholders, beneficiaries, attorneys and families of the deceased employee, providing them with superior customer service, and answering any questions they may have.  As a secondary role, you will review Group Life claims submission for completeness and accuracy. Records data in the Group Life Claims system for adjudication and determines if claim documentation will need to be reviewed by a Claim Examiner.


Key Responsibilities:

  • Handles telephone inquiries from policyholders, beneficiaries, attorneys and families of deceased employees.
  • Answers complex questions related to Group Life Claim insurance benefits.
  • Provide guidance to beneficiaries on claim processes and resolve customer issues swiftly and thoroughly.
  • Identifies areas for improvement and participates in the development of better operational processes.
  • Reviews Group Life claim documentation or other company forms when assisting callers.
  • Evaluate Group Life claim submissions for accuracy to ensure correct claim payment.
  • Evaluate Group Life claim submissions to identify situations requiring referral to Claim Examiner.
  • Reviews data from various sources, including policyholders; translates it into appropriate media for input into a Windows based computer system (BIOS).
    • Completes all work within turnaround time to meet department and customer objectives.
  • Maintain production and quality standards.
  • Ensure compliance with state regulations for Group life claims by sending appropriate notifications.
  • Perform support functions as needed.
  • Provide high quality, timely service to policyholders, beneficiaries, attorneys, families of deceased employees and administration; resolve customer issues swiftly and thoroughly by offering recommendations and solutions.
  • Mentor Reviewers as needed


Essential Business Experience and Technical Skills:

  • Strong data entry skills required.
  • Excellent oral and written communication skills.
  • Ability to adjust to multiple demands and shifting priorities


  • College Degree



“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 #: 106884 

Nearest Major Market: Utica