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
Job Type: Full-time
Pay: ₹8,086.00 - ₹38,894.27 per month
Work Location: In person
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