Dental Claim Review Coordinator

Job Location: United States : New York : Oriskany

Alternate Job Location: United States : New York : Oriskany || United States : Florida : Tampa || United States : North Carolina : Cary

Work Arrangement: Virtual

Role Value Proposition: 

Global Claims Operations is looking for unique talent with fresh perspectives that can propel innovation. In this role you will participate and assist in operational planning to dental claims and/or provider operations and the implementation of strategic initiatives. You will act as a liaison between the business and IT personnel to support the unit’s technology needs; represent user area in all system enhancements and design activities. You will review user requests, conduct data gathering interviews, documents business specifications, and manages technology projects until completion. Creates and documents business policies and procedures as it pertains to system enhancements or processing changes and efficiencies.

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Principal Responsibilities:

• Assist with re-engineering business processes with focus on continuous improvement and overall operating efficiency.
• Maintain and report daily, weekly, monthly, quarterly and annual reports including forecasting, analysis and proactive planning to assist the organization in reaching its operational and financial goals including, but not limited to, inventory, capacity, budget and other key performance indicators.
• Oversees all aspects of small projects and/or phases of larger project and serves as a liaison between the business and the IT team translating business needs into business requirements, partners with the test team and provides updates to business leadership regarding project status.
• Analyze and troubleshoot workflow, processing and/or systems issues in partnership with both internal and external business partners and participates in root cause problem solving (RCPS) meeting sessions.
• Performs other related duties as assigned or required.
• Manages critical relationships with IT, consultants/vendors, internal end users, business leaders and customers.
• Coordinate the distribution and assignment of work.
• Develops action plans and coordinates implementation of solutions relevant to backlog of inventory.
• Prepare cost benefit analysis of proposed enhancements/efficiencies for new projects when required.

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Knowledge/Skills/Competencies Required:

• Ability to work independently and multi-task with minimum supervision in a dynamic work environment.
• High School Diploma
• Ability to work with people at all levels of the organization: Vice President, Asst. Vice President Director, Manager, Supervisor, and Associates.
• Focuses on Customers and Produces Results
• Excellent oral and written communication skills.
• Excellent analytical and problem-solving skills.
• Ability to meet deadlines, providing accurate and thorough results.
• Resourcefulness, diplomacy, tact and ability to handle stress.
• Excellent interpersonal skills.
• Good time management and organization skills.
• Professional manner dealing with internal and external customers.

Preferred

• Bachelor’s degree in related field or equivalent experience
• Ability to create and deliver formal presentations
• Proficient in Excel, Word, PowerPoint
• Working knowledge of Microsoft Access, Visual Basics and SQL
• Working Knowledge of the IT Governance Agile Processes
• EDI Experience and Knowledge/ Knowledge of Provider procedures and systems
• 5 years of Dental Claims Knowledge and Experience
• HIPAA Transactions and Code Sets and working knowledge of 835/837 and 270/271
• Knowledge of Dental, procedures and systems.

At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers.

MetLife:

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 help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.

We are one of the largest institutional investors in the U.S. with $642.4 billion of total assets under management as of March 31, 2021. We are ranked #46 on the Fortune 500 list for 2021. In 2020, we were named to the Dow Jones Sustainability Index (DJSI) for the fifth year in a row. DJSI is a global index to track the leading sustainability-driven companies. We are proud to have been named to Fortune magazine’s 2021 list of the “World’s Most Admired Companies.”

MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife. For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.

MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

MetLife maintains a drug-free workplace.