Reimbursement Coordinator - 8887

Description and Requirements
Highly specialized job function that is responsible for claim analysis and claim processing for long term care services. This position is also accountable for reviewing claims for accuracy, timeliness, completeness and eligibility for multiple groups with varied benefits.
Location: Must live within a commutable distance of the Oriskany, NY, Tampa, FL, Bloomfield, CT Cary, NC, Aurora, IL, Bridgewater, NJ, Omaha, NE, Warwick, RI, Clark Summit, PA, San Juan, PR office
Once a month in office for meetings - 1st Thursday of every month
Key Responsibilities

• Virtual role predominately work from a home office with required monthly visit to the assigned GCSO office
• Analyze and process claims in a productive environment through our TLC claim system
• Appropriately interpret a variety of plan provisions and process claims accordingly, calculating claim payments and overpayments
• Review claims for receipt of all needed documentation and make outbound calls to providers for additional information
• Collaborate with our Claim Support Specialists, Customer Call Center , Plan of Care Team and Benefit Eligibility Coordinators to provide a seamless claims experience
• Abide by department guidelines and appropriately follow up on necessary tasks to process claims
• Meet quality review standards of processed claims
• Meet performance standards for financial accuracy, processing accuracy and claim timeliness
• Respond to insured inquiries regarding specific claim details via telephone conversations and/or written correspondence
• Gather and analyze information skillfully to identify and resolve problems in a timely manner

Essential Business Experience and Technical Skills
Required:

• Excellent analytical and mathematical skills
• Ability to pay attention to detail
• Ability to comprehend and apply varied rules to multiple policies
• Works well in a team environment
• Excellent organizational skills
• Proven ability to meet quality and time standards
• Basic knowledge of computer system, Microsoft Word, and Excel

The salary range for applicants for this position is $45,000 - $57,000.
Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the 2024 "World's Most Admired Companies", Fortune World's 25 Best Workplaces™ for 2024, as well as the 2025 Fortune 100 Best Companies to Work For ®, 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 individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by empathy, we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
If you need an accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.
MetLife maintains a drug-free workplace.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
$45,000 - $57,000