MetLife is a leading global provider of insurance industry serving 90 million customers in more than 60 countries all over the world. The company offers Individual and Group Insurance Plans in Life, Personal Accident, Health and Pension, providing comprehensive protection to 600.000 insured all over the country.
We are seeking for the Group Claims department the right individual to assume the position of
Claims Administrator
(Code: CLA)
Overview of the role:
Responsible for the review of claims, this includes gathering information required to substantiate claims, reconciling the claim against policy terms and conditions and proceeding to approving or denying the claim.
Major Duties and Responsibilities:
- Deciding upon claim eligibility by reviewing insurance policy terms and conditions.
- Updates claim reserves through company’s system.
- Calculating claim payments using calculation method per each policy
- Proceeding to payments of claims through company’s system
- Co-operating with company’s partner doctors in order to get medical guidelines regarding the correct claim evaluation.
- Communicating (oral or written) with customers and / or major partner client executives in order to:
- Handle complaints and provide explanations of policy terms / claim calculations.
- Ask additional clarifications in order to gather all information necessary for the accurate evaluation of claims.
- Communicating with medical centers staff in order to exchange all necessary related information when handling direct payments claims
- Communicating with other departments (IT/ POS/ Accounting etc) regarding the solution of claim related issues such as technical problems, general policy issues or bank and accounting issues
Qualifications / Skills / Experience required:
- University degree (e.g. Economics, Mathematics, Business Administration).
- Advance computers skills (MS office)
- Communication skills – Team Player Mentality
- Analytical skills – Detail Oriented
- Goal Oriented
- Strong organizational skills
- Able to make decisions on a regular basis
- Able to negotiate
Our company offers a competitive remuneration package, continuous training and opportunities for further career development in a friendly and fast paced working environment.
Send CV : resumes.hr@metlife.gr
