avature
Sr Insurance Associate
MetLife
Noida, IND
Full-time
Mid
Hybrid
Discovered 3 weeks ago
HIPAAICTCPT
Free
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HIPAAICTCPT
Role Overview
Dental Claims & Services operations is the MetLife correspondence queues contain processing of dental claims basis the response received from the customer and review the email queries in detail and provide correct response following thorough research for all dental products.
Claims are thoroughly researched and reviewed to determine approval, non‑payment, referral, or the need for additional information. Email inquiries typically involve questions about coverage, claims status, policy status, and Met Dental profile–related issues.
Key Skills for This Role
HIPAAICTCPT
Full Job Posting
Position Summary
Dental Claims & Services operations is the MetLife correspondence queues contain processing of dental claims basis the response received from the customer and review the email queries in detail and provide correct response following thorough research for all dental products.
Claims are thoroughly researched and reviewed to determine approval, non‑payment, referral, or the need for additional information. Email inquiries typically involve questions about coverage, claims status, policy status, and Met Dental profile–related issues.
Job Responsibilities
- Scrutinizing dental claim documents & settlements
- Process claims as per the set healthcare guidelines
- Respond to customer requests via multiple sources, providing excellent service to MetLife’s customers who have insurance or other financial service products or benefit plans.
- Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.
- Follow HIPAA guidelines
- Accurate processing of Dental claims and meeting productivity targets
- Good understanding of Claims adjudication fundamentals
- Good understanding of ICT & CPT Codes
- Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
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