Claims Examiner
Job Description
The Team You Will Join
On MetLife’s Global Customer Service and Operations (GCSO) team, customer care is built on trust, empathy, and a commitment to continuous improvement. Whether guiding customers through life’s important moments, solving challenges, or simplifying processes with innovative technology, you’ll help deliver a differentiated experience grounded in operational excellence. Backed by a collaborative team, you’ll play a vital role in strengthening the way we care and advocate for millions worldwide. Here, making a real difference isn’t just a goal - it’s what we do, one conversation at a time.
The Opportunity
The Claims Examiner implements the Company’s established standards and procedures in examining and resolving medical claims whilst maintaining high-quality customer service and ensuring legal compliance.
The claims team consists of 5 team players, with strong communication and collaboration. Shared goals and objectives are focused on team colleagues supporting each other and giving their maximum effort to achieve a common goal and achieve the workflow effectively and efficiently.
Key Responsibilities
- Process and review Individual and Group claim cases as per the written terms and conditions of the policies, in a timely and accurate manner
- Determine the validity of the claim and communicate with internal departments to review the terms of the Policy;
- Ensure completeness and accuracy of claim documentation and contact claimants directly to request any missing information or verification;
- Liaise with medical and state institutions in order to collect additional information and/or evidence;
- Contact medical advisors for expert claim evaluation where necessary;
- Maintain the claim database and ensure required documentation is accurately collected and properly filed;
- Maintain appropriate written records from treating physicians, legal advisors and other experts regarding the claims;
- Inform supervisor of any suspicions for fraud or misrepresentation of facts;
- Perform final claim assessment and settle the claims with payment or rejection;
- Authorize claim payments;
- Follow communication guidelines for informing claimant of decisions;
- Set and adjust the claim reserves;
- Prepare and submit reports related to claims;
- Effectively handle customer inquiries, with the aim of achieving the highest standards of customer satisfaction;
- Ensure all claims information remains confidential;
- Identify areas of improvement and make appropriate suggestions;
- Ability to use approved AI tools to support routine tasks such as drafting, summarizing, organizing information, and improving day-to-day efficiency.
Required Qualifications
- University educated to degree level, in the health sector or other relevant area e.g. insurance
- A minimum of 2 years of experience in a similar position, undertaking Health Claims assessing/examining/relevant Health Medical experience,
- Broad knowledge of medical terminology;
- Excellent knowledge of MS Office (Excel, World and Outlook);
- Fluent communicator in Greek and English, both written and spoken;
- Proven ability to plan and prioritize work, manage time and respond efficiently to changing circumstances;
- Team player with effective communication and interpersonal skills;
- Attention to detail and high-level of accuracy;
- Customer-orientation;
- Analytical thinking and problem-solving ability;
- Resilient personality with the ability to promptly address multiple requests;
- Working knowledge of AI capabilities with the ability to evaluate and validate outputs with guidance;
Preferred Qualifications
- Medical/Life Claims assessing/examining
The expected salary range for this position is €22,100 - €25,000 per annum. This role may also be eligible for annual short-term incentive compensation. All incentives and benefits are subject to the applicable plan terms.
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