Specialist
Job Description
The primary function of the Nurse Reviewer is to evaluate Statement of Health applications for Life coverages for Group customer. Also determine the need for additional medical information and decision making regarding the insurability of an applicant based on MetLife’s Medical Underwriting Guidelines. Provide guidance to SOH Reviewer 1 & 2 on need basis.
The key deliverables of the role will include but will not be restricted to the details below:
- Review customer Statement of Health form and make decisions regarding approval, denial, the need for further investigation in the form of medical records or exams
- Understand the US medical underwriting guidelines and navigate for relevant actions to be taken while initiating the final decision basis received medical records from physician (APSQ and APS)
- Review medical condition report (Paramed & Exam- Blood & Urine Report) and validate the suggested medical treatment/medication
- Understand the conditions for the prescribed medicines by physician
- Identify and obtain missing information required to process approve & decline condition
- Review Statement of Health procedures by using the defined SOP
- Adhere to agreed timelines and SLA’s
About MetLife
Recognized on Fortune magazine’s list of the 2024 “World’s Most Admired Companies” and Fortune World’s 25 Best Workplaces™ for 2024, 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!