MetLife Jobs – BSc Biotech, Biochem & Microbiology Apply Online For Hybrid Work Opportunity
Specialist
Country: India
Working Schedule: Full-Time
Work Arrangement
Hybrid
Relocation Assistance Available: No
Posted Date: 23-Jul-2024
Job ID: 3653
Description and Requirements
Job Description – Life Statement of Health
Position Title: Associate/Sr. Associate (R3 & APSQ)
Function, Responsibility Level: Operations, Specialist
Reports to (Responsibility Level): TL / AM / UM
Supervises: NA
Location: Jaipur
Global Grade: 9
Cost Center: 10020441
Complexity: T5C3-
PID/s Load Mapping: INS-002
Position Summary
Basic Function
The primary function of the Nurse Reviewer is to evaluate Statement of Health applications for Life coverages for Group customers. Also, determine the need for additional medical information and decision-making regarding the insurability of an applicant based on MetLife’s Medical Underwriting Guidelines. Provide guidance to SOH Reviewer 1 & 2 on a need basis.
The key deliverables of the role will include but will not be restricted to the details below:
- Review customer Statement of Health form and make decisions regarding approval, denial, or the need for further investigation in the form of medical records or exams.
- Understand the US medical underwriting guidelines and navigate for relevant actions to be taken while initiating the final decision based on received medical records from physician (APSQ and APS).
- Review medical condition reports (Paramed & Exam – Blood & Urine Report) and validate the suggested medical treatment/medication.
- Understand the conditions for the prescribed medicines by physician.
- Identify and obtain missing information required to process approve & decline conditions.
- Review Statement of Health procedures by using the defined SOP.
- Ensure that the allocated reports/certification requests are completed within recommended timelines and accuracy thresholds.
- Adhere to agreed timelines and SLA’s.
Knowledge, Skills and Abilities
Education
- Graduation or Diploma in Biosciences (Bachelor in Pharmacy, Degree in Biotechnology, Degree in Biochemistry / Microbiology / Nursing, Diploma in Pharmacy).
Experience
- Professional with 3-4 years of work experience in the BPO industry, preferably under medical transcription and medical summarization for US Insurance.
Knowledge and skills (general and technical)
- Excellent Knowledge of Medical Terminology & medicines
- Computer navigation skills
- Basic knowledge of MS Office
- Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
- Exposure to multiple mainframe and web systems
- Good analytical skills with an ability to research & take decisions to resolve problems in underwriting
- Knowledge of Insurance principles in relation to the US Insurance industry
- Knowledge about US Culture
- Strong organizational skills
- Good communication skills both written & verbal
- Demonstrate ability to work independently and in a team environment
- Self-disciplined and results-oriented
- Ability to multitask
- English language skill – should be able to read, comprehend, and write correctly
- Must be open to working in shifts
Other Requirements (licenses, certifications, specialized training – if required)
- Diploma/Degree in pharmacy
Working Relationships
Internal Contacts
- AM/TL for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking feedback and support as well as associate development.
- Manager for the purpose of settling issues left unresolved by the AM/TL and monthly evaluation of performance.
- Quality Compliance Analyst (QCA) for the purpose of feedback and audit.
- Trainers for the purpose of pre-process and process training.
External Contacts
- MetLife Subject Matter Experts for the purpose of seeking missing information.
- MetLife Subject Matter Expert for the purpose of work-related issues and escalated transactions.
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