Pet Claims Team Lead

Location - Virtual
Shift: 5 days a week, including every weekend (Saturday and Sunday). Candidate can choose their 2 days off during the week (not weekend).
Shift Hours - 8-4:30pm or 9-5:30pmEDT.

Position Overview:

The Claims Team Lead will work directly on the Claims floor and serve as a conduit between the Claims Supervisor and the Claims team. The Team Lead is responsible for advanced knowledge of MetLife Pet/PetFirst coverage, policies, and procedures as well as having the ability to interpret, code and understand medical terminology in relation to diagnoses and procedures. The Team Lead must also be able to accurately relay this information to the team. The Team Lead will work closely with the Customer Experience and Sales Team Leads to address and resolve customer issues related to claims. The Team Lead will coach team performance and work with their Manager to ensure team production and service goals are consistently met.

This role requires a high energy person capable of strategic thinking and leadership, problem solving, multi-tasking as well as attention to detail in day to day operational procedures.

Essential Duties and Responsibilities:

• Provide daily direction and communication to claims associates to ensure the team is performing optimally

• Expeditiously and efficiently resolve customer escalated issues resulting from claim adjudication which may result in email or phone communication with the customer or vet

• Provide policy clarification to claims associates

• Coach claims’ associates behaviors toward the company’s goals and assist Manager with gathering information for performance reviews

• Monitor real-time associate activity and address production and quality issues as needed

• Perform administrative tasks including, but not limited to, customer escalations, inter-department communication and claims adjudication requests.

• Assists Supervisor with analyzation and presentation of department metrics

• Adjudicates for allocation of deductibles, co-pays, co-insurance maximums and provider reimbursements

• Procures and maintains adjuster’s license in all relevant states

• Perform all other duties as assigned

Essential Knowledge, Skills, and Abilities:

Required:

• 
  High school diploma or GED
• Three years veterinary medical experience or equivalency required
• 4+ years pet insurance adjuster experience
• Proven leadership experience and conflict management skills

P&C License Required as a condition of employment (must be obtained within 3 months of hire)

Preferred:

• Strong understanding of veterinary medical terminology (Vet Tech License a plus)

• Articulate, professional, and possesses a strong quality customer service mindset with attention to detail with excellent tracking, follow-up, and relationship building skills

• Ability to identify problems and logically research with minimum assistance to locate answer through appropriate reference materials

The wage range for applicants for this position is $45,000. This role is also eligible for annual short-term incentive compensation. MetLife offers a comprehensive benefits program, including healthcare benefits, life insurance, retirement benefits, parental leave, legal plan services and paid time off. All incentives and benefits are subject to the applicable plan terms.