LTC Care Coordinator - 12/9/24

Description and Requirements
Role Value Proposition:
Global Operations focuses on creating positive experiences for MetLife customers and helping the company make the best use of its global resources. We're looking for unique talent with fresh perspectives that can propel innovation. In this role you will evaluate long-term care claims and exercises independent judgment, discretion, and critical analysis to reach reasonable claims determinations that are in accordance with contract provisions and time service standards
LOCATION : Virtual, BUT MUST BE COMMUTABLE TO TAMPA, FL. TRAINING IS IN-OFFICE FOR 12 WEEKS.
Key Responsibilities :
• Manages assigned caseload of initial eligibility files with limited supervision.
• Utilizes critical thinking and independent judgment and analysis to provide timely, balanced, and accurate claims decisions in a time sensitive, compliance driven and fast paced environment.
• Compiles file documentation requiring extensive policy and factual detail.
• Identifies information and resources needed to make initial benefit eligibility determinations, to include review of detailed medical information and other documentation necessary for rendering initial eligibility decision.
• Communicates decisions to policyholders and or their representatives in both verbal and written form.
• Composes highly detailed letters to policyholders and or their representatives outlining status of review and basis of determination.
• Clarifies and reconciles inconsistencies.
• Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information.
• Engages with various medical and legal resources in situations where warranted.
• Represents MetLife at deposition and trial due to first party litigation environment.
Essential Business Experience and Technical Skills:
Required
• Strong communication skills, both written and oral
• Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
• Experience using MS office products
• Strong organizational skills.
• High School Diploma/GED and 3-5 years related experience
Preferred
• Bachelor's Degree
• 2-4 years professional experience
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 $600 billion of total assets under management as of December 31, 2019. We are ranked #44 on the Fortune 500 list for 2019. In 2019, we were named to the Dow Jones Sustainability Index (DJSI) for the fourth year in a row. DJSI is a global index to track the leading sustainability-driven 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. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [email protected] or call our Employee Relations Department at 1-877-843-3711.
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.
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" as well as the 2024 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!
Equal Employment Opportunity/Disability/Veterans
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.