Role Description The Clinical and Coding Quality Supervisor provides direct operational leadership and subject matter oversight for all daily clinical and coding quality workflows and assignments. This role is responsible for ensuring the accuracy, consistency, and effectiveness of second-level coding quality review workflows that support: - Risk adjustment - DRG integrity - Regulatory compliance - Institutional quality and financial performance Promote and support teamwork and engagement, performance excellence, accountability, and professionalism. Lead and support process improvement. Ensure the Clinical & Coding Quality Team have the education and tools they need to successfully perform to the highest levels of quality and compliance. Qualifications - Associate's Degree in nursing or health information management - 5 years of experience working in an Acute Hospital setting, preferably in an Academic environment - 3 to 5 years of experience working in a Quality/Risk Program - Experience utilizing methodology-specific risk calculators and guidance documents - Experience working in a remote environment - Licenses and Certifications: - Registered Health Information Management (RHIA) - Registered Nurse (RN) with Certified Clinical Documentation Specialist (CCDS) - Registered Health Information Technology (RHIT) - AHIMA Certified Coding Specialist (CCS) - Preferred: Bachelor's Degree in nursing or health information management Requirements - Manage staffing and all employee-related duties - Provide day-to-day supervision of Coding Quality Analysts, including work assignment, prioritization, performance monitoring, and issue resolution - Oversee all quality workflow and assignments - Ensure quality changes are completed within revenue cycle goals and corrections are completed within deadlines - Serve as the primary escalation point for complex CDI, coding, DRG, and risk-adjustment questions requiring advanced review - Oversee coding quality audits validating ICD-10-CM/PCS code assignment accuracy - Track, trend, and report quality metrics, including error rates, rework, and risk-adjustment performance - Identify front-end workflow issues impacting coding quality and recommend process improvements - Collaborate with Denials Team processes and initiatives - Maintain an expert level of knowledge of Coding, CDI, Denials, and Appeal guidelines and practices - Onboard, train, and audit all direct reports - Support the Quality Standards set by UTSW & the Coding Quality & Integrity Department - Other duties as assigned Benefits - PPO medical plan, available day one at no cost for full-time employee-only coverage - 100% coverage for preventive healthcare - no copay - Paid Time Off, available day one - Retirement Programs through the Teacher Retirement System of Texas (TRS) - Paid Parental Leave Benefit - Wellness programs - Tuition Reimbursement - Public Service Loan Forgiveness (PSLF) Qualified Employer

Description and Requirements 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 Claim Reviewer is responsible for providing high quality review and payment of claims, and also provide compassionate service to our beneficiaries and families of deceased employees to assist with the claims process across the country . This is an exciting opportunity to learn the Group Life claims process and potential to further your development, while making a positive impact on our claimants. Key Responsibilities - Checks Group Life claim documentation or other company forms for completeness and accuracy. - Evaluate Group Life claim submissions for accuracy to ensure correct claim payment. - Evaluate Group Life claim submissions to identify situations requiring referral to Claim Examiner. - Reviews data from various sources, including policyholders; translates it into appropriate media for input into a Windows based computer system (BIOS). - Respond to written and/or telephone inquiries from policyholders, beneficiaries, attorneys and families of deceased employees. - Provide guidance to beneficiaries on claim processes and resolve customer issues swiftly and thoroughly. - Completes all work within turnaround time to meet department and customer objectives. - Maintain production and quality standards. - Ensure compliance with state regulations for Group life claims by sending appropriate notifications. - Perform support functions as needed. - Provide high quality, timely service to policyholders, beneficiaries, attorneys, families of deceased employees and administration; resolve customer issues swiftly and thoroughly by offering recommendations and solutions. - Mentor Reviewers as needed - Provide compassionate call outs to claimants to assist with the claims process and offer additional services. Required Qualifications - New hires should live a commutable distance from Oriskany NY. - Strong communication skills, both written and oral. - Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning. - Experience with Microsoft Suite (Word, Excel, Teams, etc.) - 1+ years Customer Service background with a focus on delivering white glove service to clientele. - High School Diploma or GED equivalent. - This role has mandatory paid training starting on September 8. Candidates must be available and present for all training days. Preferred Qualifications - 1+ years' experience in a call center. Focus on outbound calls preferrable. - Prior experience reviewing insurance claims. - Background in Life Claims (Claim intake and Notice of Loss). - College Degree or high education. The expected salary range for this position is $41,600 - $54,000 . This role may also be eligible for annual short-term incentive compensation and stock-based long-term incentives. All incentives and benefits are subject to the applicable plan terms. 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, paid time off, paid holidays, volunteer time off, tuition assistance and much more! About MetLife Recognized on Fortune magazine's list of the "World's Most Admired Companies", Fortune World's 25 Best Workplaces™, as well as the 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 our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - 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 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. 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.

• Review patients' complete medical charts to assess eligibility for surrogacy candidacy • Identify red flags or exclusionary criteria that would prevent a candidate from becoming a surrogate • Document and summarize clinical findings within HIPAA-compliant, secure software • Provide direction to the clinical/nurse team or collections team following each review • Collaborate with your manager to escalate or clarify complex or borderline cases • Maintain strict confidentiality and adhere to all relevant privacy regulations

• Review medical case files including petitions, medical records, affidavits, depositions, and supporting documentation. • Assess adequacy of information and evaluate likelihood of causation using medical principles and literature. • Prepare written reports and recommendations for legal and administrative teams. • Consult with medical experts, team leads, and attorneys as needed. • Participate in case presentations and consensus discussions. • Ensure compliance with records management, HIPAA, and confidentiality standards. • If required, provide testimony in legal proceedings (travel reimbursed under federal travel guidelines).