MetLife

 Location:  Must live within a commutable distance of the Tampa FL Office only 

In office once a month for in office meetings

12 weeks In Person Training

 Key Responsibilities:

· Manages assigned caseload of initial eligibility files 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 initial benefit eligibility determinations, to include review of detailed medical information and other documentation necessary for rendering initial eligibility decision.

· 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. 

· 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