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Care Coordinator - LTC

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Date Posted: Mar 21, 2023

Location(s): Tampa, FL, US, 33647

Company: MetLife

Location: Virtual within a commutable distance of Tampa, FL (New Hires should live within a commutable distance of the Tampa, FL location)

 

Role Value Proposition: 

Global Operations 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 you will evaluate long-term care claims and exercises independent judgment, discretion, and critical analysis to reach reasonable claims determinations that are in accordance with contract provisions and time service standards.

 

 Key Responsibilities:

  • Manages assigned caseload with limited supervision.
  • Utilizes critical thinking and independent judgment and analysis to provide timely, balanced, and accurate claims decisions in a time sensitive, compliance driven and fast paced environment.
  • Compiles file documentation requiring extensive policy and factual detail.
  • Identifies information and resources needed to make benefit eligibility determinations, to include review of detailed medical information and other documentation necessary for rendering eligibility decision.
  • Eligibility decisions have a substantial financial impact.
  • Communicates decisions to policyholders and or their representatives in both verbal and written form.
  • Composes highly detailed letters to policyholders and or their representatives outlining status of review and basis of determination. Letters are compliance driven and require substantive evidence of support.
  • Clarifies and reconciles inconsistencies.
  • Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information.
  • Engages with various medical and legal resources in situations where warranted.
  • Represents MetLife at deposition and trial due to first party litigation environment.

 

Essential Business Experience and Technical Skills:


Required

  • Strong communication skills, both written and oral
  • Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
  • Experience using MS office products
  • Strong organizational skills.
  • High School Diploma/GED and 3-5 years related experience

 

Preferred

  • Bachelor’s Degree
  • 2-4 years professional experience

 

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 one of the largest institutional investors in the U.S. with $600 billion of total assets under management as of December 31, 2019. 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.

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife.  If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to accommodations@metlife.com or call our Employee Relations Department at 1-877-843-3711.

 

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.

 

MetLife maintains a drug-free workplace.

 

 

Business Category

Operations: Customer Service

 

Number of Openings

8


Nearest Major Market: Tampa