Pet Claims SME

Description and Requirements
Pet Claims SME (Senior Product Claims Analyst 09M)
Position Overview:
The Pet Claims SME will work directly with the Pet Claims Team Leaders, Pet Agile Team and other areas of the MetLife Pet Team to share advanced knowledge of the MetLife Claims Team procedures and systems. The Claims SME is responsible for expert level knowledge of MetLife Pet coverage, policies, procedures, Claims Team Reporting, the Pet Claims System and PETS. In addition, the Claims SME can interpret, code, and understand medical terminology in relation to diagnoses and procedures and accurately explain claims decisions and veterinary medical records to others when needed. The Claims System SME must analyze, log, and accurately respond to Pet Claims System and PETS issues and enhancements that would increase adjuster and Documentation Specialist performance and improve the customer experience. In addition, examine, analyze, and share data to document common trends that enhance processing practices across MetLife Pet.
This role requires a detail-oriented person with critical thinking and analysis skills. Additionally, this role requires the ability to identify problems, logically research with minimum assistance to locate answer through appropriate reference materials.
Essential Duties and Responsibilities:
• Provide policy and Claims procedure clarification to all areas of MetLife Pet.
• Meticulously logs, tracks, and follows up on all Claims System and PETs enhancements and issues that impact the Claims Team.
• Assists Supervisor with analyzation and presentation of department metrics.
• Perform administrative tasks including, but not limited to, customer escalations, inter-department communication and Department of Insurance inquires.
• Procures and maintains adjuster's license in all relevant states.
• Perform all other duties as assigned.
Essential Knowledge, Skills, and Abilities:
• Proven understanding of policy provisions and insurance terminology.
• Strong understanding of veterinary medical terminology.
• Expert knowledge and use of Pet Claims System, PETS and Claims Reporting.
• Articulate, professional, and possesses a strong quality customer service mindset with attention to detail.
• Strong written and oral communication skills including presentation, tracking and follow up skills.
• Strong organization skills and the ability to handle multiple projects at once.
• Proficient with Microsoft Office programs (Outlook, Excel and Word).
• 3+ years' experience as a MetLife Pet Claims Adjuster.
Beneficial Knowledge, Skills, and Abilities:
• Vet Tech License
• Property and Casualty Adjuster License
The salary range for applicants for this position is 53,000.
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", Fortune World's 25 Best Workplaces™ for 2024, 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!
MetLife is an Equal Opportunity Employer. All employment decisions are made without regards to race, color, national origin, religion, creed, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, marital or domestic/civil partnership status, genetic information, citizenship status (although applicants and employees must be legally authorized to work in the United States), uniformed service member or veteran status, or any other characteristic protected by applicable federal, state, or local law ("protected characteristics").
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.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liabilities.
53,000