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).

Role Description Are you an accomplished Board Certified Spine Surgeon or Board Certified Neurosurgeon? Are you passionate about your work/life balance? We are seeking flexible and experienced physicians for our medical reviewstream division. This telecommute role provides the ability for you to customize your schedule and caseload within a Monday - Friday work week and within business hours. Create a flexible work schedule and be compensated on a per case basis as a 1099 independent contractor. Candidates must have a NJ license. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities - Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers’ compensation claims. - Meets (when required) with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues. - Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job. - Returns cases in a timely manner with clear concise and complete rationales and documented criteria. - Telephonically contacts providers and interacts with other health professionals in a professional manner. Discusses the appropriate disclaimers and appeal process with the providers. - Attends orientation and training. - Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits. - Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer reviewed literature that support sound and objective decision making and rationales in reviews. - Provides copies of any criteria utilized in a review to a requesting provider in a timely manner. Qualifications - Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services. - Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board). - Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. - Must be in active medical practice to perform appeals. - Post-graduate experience in direct patient care. - Demonstrated computer skills, telephonic skills. - Demonstrated ability to perform review services. - Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. - Medical direction shall also be provided consistent with the requirement that the physician advisor shall not have a financial conflict of interest. - Must present evidence of current error and omissions liability coverage for job duties and activities performed. - Managed care orientation. - Knowledge of current practice standards in specialty. - Good negotiation and communication skills. Requirements - Phone accessibility. - Access to a computer to complete reviews. - Ability to complete cases accompanied by a typed report in specified time frames. - Telephonic conferences. Benefits - This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management. Company Description Concentra is an Equal Opportunity Employer M/F/Disability/Veteran. Concentra is committed to protect patient data and to ensure privacy of personal and medical information. Every Concentra colleague has the responsibility to adhere to data protection principles. If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information. This position is an independent contractor role for Concentra. Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.