Specialist Job In Metlife In India, Noida

Basic Function Handle and administer Family & Medical Leave Act standalone (as well as other leave) claims and adhere to federal and state regulatory and/or company plan requirements and established FMLA workflow procedures Complete eligibility decisions and review for entitlement, gather pertinent data when necessary, from employee, physicians office or employer through outgoing calls, email, fax or other supporting systems Promptly review new FMLA and other leave claims within regulatory timelines, evaluate against appropriate leave plans and make initial claim decision.

Perform leave administration tasks as required, including recertification of health condition, intermittent claim tracking, RTW confirmation, return phone calls, etc Update systems to accurately reflect leave status and ensure appropriate diary documentation exists Business recommended TAT to complete the activity is up to 5 business days to maintain compliance measures .

The position is expected to do absence management and adjudication on Federal, State and company leaves Interact with claim specialist, claim support specialist, QA, Claims Unit Leader (stateside supervisors), employees, employers/customer and physician's office Essential Functions: Analyze, validate and process transactions as per Desktop procedures (L3 & L4) Analyze and research all discrepancies .

Research & Investigate and resolve outstanding items Determine eligibility, entitlement and applicable plan provisions while meeting timeliness goals Clear and accurate written and verbal communication (Mix of scripted/unscripted) with employee, employer & stateside resources by email and outgoing calls Establish action plans for each file to bring claims to resolution Utilize internal and external specialty resources to maximize impact on each claim file .

Use PC programs to increase productivity and performance Ensure that the assigned targets are met in accordance with SLA, Performance Guarantee and Internal standards Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence Work as a team member to meet office goals to obtain disability's vision while demonstrating core values and meeting key measures Ensure adherence to established attendance schedules .

Close visual activity - viewing a computer terminal and extensive reading Any other essential function that may occur from time to time as directed by the Supervisor Skills Technical Skills Good computer navigation skills Good keyboarding speed Good knowledge of complete MS Office suite Process Specific Skills .

Knowledge about the Insurance industry in US Knowledge about US Culture Knowledge of Insurance principles Soft skills (Mandatory / Desired) Communication skills - should be able to read, interpret business documents Good verbal/written communication .

Proficiency in English - Spoken and Written Analytical and interpersonal skills Escalate issues if required Data gathering ability/ Eye for detail Team work/ Managing Self / Adaptability .

Ability to work successfully in production driven environment Adaptability to change Ability to work on routine/standardized transactions Desired: Self disciplined and result oriented Ability to multi task .

Ability to work effectively as part of a team Knowledge of Medical Terminology (preferred but not compulsory) Preferred: Claims, specifically disability, preferred Working knowledge of FMLA/Disability/Leave procedures preferred Knowledge of system applications preferred Education Requirements Graduate with at least 15 years of education.

Work Experience Requirements Minimum 3-4 years of experience in a transactional, blended process of insurance or related industry with relevant experience of working in a business environment (preferred but not compulsory)

Metlife is looking for .

Metlife is looking for Any Graduate / Post Graduate profile candidates.