29 days old
2018-01-232018-02-22

Provider Control Unit Reviewer

MetLife
Oriskany, NY 13424
**Job Location:** Oriskany, NY







**Role Value Proposition:**







At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Global Technology & Operations group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to create innovative and solutions to address core business challenges with MetLife. This role will assist in the responsibilities for the overall support of the Provider Control Unit in Group Dental. The primary focus will be to research and resolve requests and applications relating to dental providers utilizing multiple electronic database files for support of the Dental Product. Responsibilities range from researching and analyzing information to handling and correcting discrepancies. Creates and maintains a positive working relationship with both internal and external customers. Responds to telephone and written inquiries from dental providers, Provider Relations Team and other external and internal customers







**Key Responsibilities:**







+ Reviews, evaluates and resolves information submitted by varied electronic and paper transmission means from multiple source entities.



+ Validates licenses, status and appropriately update systems to handle sanction issues.



+ Performs a complete evaluation to insure accuracy of data entry. Interacts with multiple internal and external representatives.



+ Routinely interfaces and consults with providers to resolve issue and concerns.



+ Utilizes multiple mainframe, PC and Internet based systems.



+ Assists providers for PDP, EFT and other MetLife sponsored dental solutions.



+ Identifies and refers any potential fraud issues. Provides personalized service for complex/escalated cases in a professional and timely manner.



+ Consults with Supervisor, Manager and Call Center regarding Provider Concerns.



+ Provides guidance and direction in regards to Electronic Funds Transfers.



+ Assists with ongoing development of written instructional manuals and other required forms to assist in the installation of new system or in the implementation of new procedures.



+ Provides management with technical data required for decision-making.







**Essential Business Experience and Technical Skills:**







Required:







+ High School Diploma



+ 1-3 years of experience in claims or customer service.







Preferred:







+ Strong communication skills, both written and oral.



+ Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.







**Travel**







_0-5%_







**Business Category**







_Global Technology and Operations_







**Number of Openings**







_2_







**At MetLife, were leading the global transformation of an industry weve long defined. United in purpose, diverse in perspective, were dedicated to making a difference in the lives of our customers.**







MetLife is a proud equal opportunity/affirmative action employer committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. It is MetLife's policy to ensure equal employment opportunity without discrimination or harassment based on 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.







**For immediate consideration, click the Apply Now button. You will be directed to complete an on-line profile. Upon completion, you will receive an automated confirmation email verifying you have successfully applied to the job.**







Requisition #: 94069

Categories

  • Customer Service
  • Engineering
  • Information Technology
  • Legal

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Provider Control Unit Reviewer

MetLife
Oriskany, NY 13424

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MetLife
Oriskany, NY
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