Care Coordinator Long Term Care Position Available In Hillsborough, Florida
Tallo's Job Summary: The Care Coordinator Long Term Care role in Tampa FL involves managing initial eligibility files, making timely claims decisions, and communicating with policyholders. This position requires critical thinking, strong communication skills, and experience with MS Office. High School Diploma/GED and 3-5 years related experience are required, with a Bachelor's Degree and 2-4 years professional experience preferred. MetLife is hiring for this position.
Job Description
Location:
Must live within a commutable distance of the Tampa FL Office only In office once a month for in office meetings 12 weeks
In Person Training Key Responsibilities:
- Manages assigned caseload of initial eligibility files with limited supervision.
- Utilizes critical thinking and independent judgment and analysis to provide timely, balanced, and accurate claims decisions in a time sensitive, compliance driven and fast paced environment.
- Compiles file documentation requiring extensive policy and factual detail.
- Identifies information and resources needed to make initial benefit eligibility determinations, to include review of detailed medical information and other documentation necessary for rendering initial eligibility decision.
- Communicates decisions to policyholders and or their representatives in both verbal and written form.
- Composes highly detailed letters to policyholders and or their representatives outlining status of review and basis of determination.
- Clarifies and reconciles inconsistencies.
- Conducts in depth detailed information-gathering phone calls that obtain medical condition details and other information.
- Engages with various medical and legal resources in situations where warranted.
- Represents MetLife at deposition and trial due to first party litigation environment.
Essential Business Experience and Technical Skills:
Required
- Strong communication skills, both written and oral
- Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning
- Experience using MS office products
- Strong organizational skills.
- High School Diploma/GED and 3-5 years related experience Preferred
- Bachelor’s Degree
- 2-4 years professional experienceEqual Employment Opportunity/Disability/Veterans If you need an accommodation due to a disability, please email us at accommodations@metlife.
com. 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.
