Job Description

Job Description

Job Description

Job description:

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 position requires the individual to work onsite in our Cleveland, OH HQ for their first week of training. After that, the position will be fully remote but may require occasional travel into the Cleveland office.

These are contract positions through  SkySource Solutions .

Schedule:

• Full-time: 40 hours/week -- Monday–Friday, 8:00 AM – 5:00 PM

Work Model:

• One-week onsite training, Fully remote thereafter (Occasional travel to our Cleveland office may be required)

Contract Details:

• Guaranteed through year end, potential for extension or permanent hire

A day in the life of a  Claims Analyst  at MetLife Legal Plans:

Our  Claims Analysts review incoming out-of-network fee reimbursement claims from our legal plan members for all aspects of accuracy. They make determinations resulting from these reviews and prepare 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’s review billings received from our Panel Attorneys for services provided to our legal plan members which include analyzing billing for correct coding, appropriate fees, and specific required information. The Claims Analyst will make the necessary corrections to these billings and continue with the billing payment process unless additional review and determination from our in-house counsel is required.

Essential Duties and Responsibilities:

Claims Analyst – Billing:

• Obtain Adjusters licenses as required to meet business needs
• Complete continuing education to maintain licenses
• Perform analysis of Attorney’s claims and determine necessary adjustments
• Work closely with MLP’s accounting department to recover Panel Attorney overpayments
• Place Attorney Claims on hold when further payment decisions or backup are required
• Determine appropriate claims notation for payment and audit purposes
• Review claims based on Analyst authority level and process reviewed claims received from in house counsel
• Send billing inquiry memos to attorneys when requiring additional details or when unable to make payments
• Process reconciliation “close”, resolving audit discrepancies before forwarding billings to MLP’s accounting department for final approval
• Other duties as assigned.

Claims Analyst – Reimbursements:

• Complete analysis of Fee Reimbursement Claims including checking eligibility, determining member specific coverage, and verifying the inclusion of all required documentation to approve payment
• Ensure all levels of member information are secure during processing
• Determine when a claim needs to have further approval and communicating the need to the appropriate individuals.
• Keep all communication avenues up to date with claims information and status.
• Support and process the Fee Reimbursement reconciliation close using MetLife Legal Plans systems, forwarding claims to be paid to accounting for final approval and release for payment
• Answer questions from our legal plan members regarding their reimbursements
• Communicate with internal teams to assist with complex Fee Reimbursement claims
• Submit documentation for appeals and check reissues
• Other duties as assigned.

Minimum Qualifications:

• 2+ years of experience in claims, settlements or accounts receivable
• Associate’s degree or in lieu of a degree, Adjusters License or Insurance License.
• Ability to multitask and work with a sense of urgency while maintaining attention to detail
• Ability to meet and deliver on Service Level deadlines
• Detail-oriented and well-organized, with the ability to effectively prioritize & 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) :

• 3+ years of experience in claims processing
• Bachelor’s degree from an accredited university
• Knowledge of claims and legal industry
• Strong attention to detail and excellent organizational skills

Claims Adjuster License 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

Company Description

SkySource Solutions believes in attaining success. We know success is important to our clients, applicants, candidates, and our internal staff and want to be an integral part of that process.
The SkySource Difference: We are not just another staffing firm! We truly care about our candidates long-term success and how we get there together. So the BIG Question is... How do we get there?
Our team of Recruiters come with 5 plus years of industry experience and are not looking to just find you a job. We truly care about your short-term and long-term career goals and understand what's important in making that next career move. We want to understand what you are looking for from a cultural, compensation and benefits perspective.

Apply today and experience the SkySource difference!

Company Description

SkySource Solutions believes in attaining success. We know success is important to our clients, applicants, candidates, and our internal staff and want to be an integral part of that process.\r\nThe SkySource Difference: We are not just another staffing firm! We truly care about our candidates long-term success and how we get there together. So the BIG Question is... How do we get there?\r\nOur team of Recruiters come with 5 plus years of industry experience and are not looking to just find you a job. We truly care about your short-term and long-term career goals and understand what's important in making that next career move. We want to understand what you are looking for from a cultural, compensation and benefits perspective. \r\n\r\nApply today and experience the SkySource difference!

Job Tags

Remote job, Permanent employment, Full time, Contract work, Temporary work, Work at office, Local area, Monday to Friday,

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