Sr. Insurance Associate

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n n General Informationn

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Location

Jaipur, Rajasthan

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n Working Schedulen

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n Full-Timen

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n Work Arrangementn

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n Hybridn

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n Relocation Assistance Availablen

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n Non

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n Posted Daten

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n 24-Jun-2026n

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n Job IDn

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n 18543n

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n n Description and Requirementsn

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Metrefer/Dental Claims Operations is the MetLife correspondence queues contain processing of dental claims basis the response received from the customer. All the claims which cannot be processed by the sub-contractor, comes in Metrefer/Dental Claims Operations queue

Work queues that have claims route to GOSC can be defined by the type of edit that requires resolution (eligibility, plan, provider or code related). Claims are researched and reviewed for approval, non-payment, referral or request for additional information.

Job Responsibilities

• Scrutinizing dental claim documents & settlements
• Process claims as per the set healthcare guidelines
• Follow HIPAA guidelines
• Accurate processing of Dental claims and meeting productivity targets
• Good understanding of Claims adjudication fundamentals
• Good understanding of ICT & CPT Codes
• Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket
• Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process
• Handle escalations
• Need to ensure quality and productivity targets are met
• Ensure compliance with internal policies and procedures, external regulations and information security standards

Knowledge, Skills and Abilities

Education

• Bachelor's degree (Any Stream) or diploma with a minimum of 15 years of education

Experience

• 2 years of work experience in US Health Claims processing preferably in claims adjudication

Knowledge and skills (general and technical)

Technical Skills

• Computer navigation skills
• Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy)
• Working knowledge of MS Excel and MS Word.
• Process Specific Skills
• Knowledge of Insurance principles in relation to the US Insurance industry
• Knowledge about US Culture
• Knowledge of Dental claims terminologies and processes will be an added advantage

Soft Skills

• Strong organizational skills
• Good communication skills
• Demonstrate ability to work independently and in a team environment
• Self-disciplined and results oriented
• Ability to multi task
• Strong understanding and comprehension of the English language
• Good PC skills
• Attention to detail
• Team player
• Positive attitude

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n About MetLife

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Recognizednon Fortune magazine''s list of the "World''s Most Admired Companies"nand Fortune World's 25 Best Workplaces, MetLife, through its subsidiaries andnaffiliates, is one of the world's leading financial services companies;nproviding insurance, annuities, employee benefits and asset management tonindividual and institutional customers. With operations in more than 40nmarkets, we hold leading positions in the United States, Latin America, Asia,nEurope, and the Middle East.

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Our purposenis simple - to help our colleagues, customers, communities, and the world atnlarge create a more confident future. United by purpose and guided by our corenvalues - Win Together, Do the Right Thing, Deliver Impact Over Activity, andnThink Ahead - we're inspired to transform the next century in financialnservices. At MetLife, it's #AllTogetherPossible.u202fJoin us!

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