Claims Analyst (Minnesota)
MetLife Legal Plans is growing and we are looking to add a Claims Analyst to our growing Panel Management Department.
This is a fully remote position, however, the selected candidate must reside in the state of Minnesota.
This individual will report directly into our Claims Supervisor.
Who We Are:
MetLife Legal Plans is the country's largest provider of legal voluntary benefits. We have more than 40 years of experience in employee legal services and are committed to providing excellent care to our plan members, sponsors and 18,000+ attorneys.
We are trusted by nearly 7 million families and more than 200 Fortune 500 companies who offer our service as an employee benefit.
It's an exciting time to join our team. We are growing quickly and have a bold vision for our future as we evolve our company to dream bigger, move faster, and use creativity and technology to build products people love.
MLP's Core 4:
• Put customers first
• Be the Best
• Make things easier
• Succeed together
This is fully remote position, however, the selected candidate must reside in Minnesota.
Standard working hours for this position are 8 a.m. to 5 p.m. with flexibility.
A Day in the Life of a Claims Analyst at MetLife Legal Plans:
The Claims Analysts review incoming out-of-network fee reimbursement claims from our legal plan members for all aspects of accuracy. They will make determinations resulting from these reviews and will prepare these claims for payment or will forward the claims on to in-house counsel for further analysis and determination. This position includes internal/external communications between our in-house counsel and our MetLife Legal Plans members. Claims Analyst Review billings received from our Panel Attorneys for services provided to our legal plan members. These reviews include analyzing a billing for correct coding, appropriate fees and specific required information completed. The Claims Analyst will make the necessary corrections to these billings and continues with the billing payment process or decides if additional review and determination from our in-house counsel is required.
Essential Duties and Responsibilities:
Claims Analyst - Billing
• Performs an analysis of Attorney's billings and determines necessary adjustments.
• Works closely with the Accounting department to recover Panel Attorney overpayments
• Puts Attorney billings on hold when further payment decisions or backup are needed
• Releases Attorney billings from the hold status when billing criteria is complete
• Determines appropriate billing noteline for payment and audit purpose
• Reconciles and resolves billing payment cycle audit discrepancies
• Processes a reconciliation "close" and sends billings to the Accounting department for final approval the release claims for payment
• Various other duties as assigned.
Claims Analyst - Reimbursements
• Analyzes claims for reimbursement of out of network attorney services
• Analysis and processing of Fee Reimbursement claims including claim form completion, ensuring that coverages of the member's specific legal plan are correctly identified, determines if proper backup and payment receipts have been included with claim.
• Keeps all levels of member information secure during processing
• Determines when a claim needs to have further approvals and is responsible for communicating the need to the appropriate individuals.
• Updates various spreadsheets for tracking purposes
• Will perform the Fee Reimbursement reconciliation close process using IBMi queries and/or other MetLife Legal Plans systems to release claims for payment
• Resolves any discrepancies while preforming the Fee Reimbursement close process
• Communicates with our legal plan members on answers to their questions and status of their reimbursements
• Various other duties as assigned.
Minimum Qualifications (Knowledge, skills, and abilities required)
• Must be a resident of Minnesota and have an active insurance adjuster license in the state of Minnesota.
• Bachelor's degree from an accredited university or equivalent work experience
• Ability to multitask and work with a sense of urgency while maintaining attention to detail
• Ability to meet assigned aggressive deadlines
• Detail-oriented and well-organized, with the ability to effectively manage a high-volume workload
• Self-motivated with the ability to take initiative and work independently as well as with a team
• Ability to communicate effectively and professionally with our legal plan members and internally with other company associates
• Proficiency with Outlook and Microsoft Office products including Excel and Microsoft Word
What Will Make You Special (Preferred knowledge, skills, and abilities)
• Previous experience in accounting or business processes
• Knowledge of industry or business
• Strong attention to detail and excellent organizational skills
• Ability to work within a team environment
Characteristics of our Claims Analysts (Competencies)
• Problem solving/analytical skills
• Time management skills
• Detail-oriented
• Deadline awareness
• Communication proficiency
• Ability to thrive in a teamwork environment
No travel required for this role.
Note: This job description in no way states or implies that these are the only duties to be performed by the associate in this position. Associates will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbent will possess the skills, aptitude, and ability to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an "at-will" relationship.
