Claims Coordinator

Description

### **General Information** **Location** Mexico City, Ciudad de Mexico Working Schedule Full\-Time Work Arrangement Hybrid Relocation Assistance Available No Posted Date 22\-May\-2026 Job ID 17861 ### **Description and Requirements** *We are global experts and recognized leaders in insurance. With over 150 years of experience, we deliver best-in-class life insurance, annuities, and benefits programs to more than 90 million customers across 50 countries. In Mexico, we are the #1 individual insurer in the country, serving over 10 million insured individuals.* We are seeking a **Claims Coordinator**. **PURPOSE OR MISSION OF THE ROLE**: Support your team in achieving organizational objectives, ensure customer requests are handled in compliance with established procedures and policies, and guarantee customer satisfaction in responding to claims. **KEY RESPONSIBILITIES** * **Leadership and Team Development**: Direct supervision of medical and administrative staff, including coaching, clinical training, and workload management to ensure adherence to corporate protocols. * **Productivity and SLA Management**: Real-time monitoring of key performance indicators (response times, case volume, documentation efficiency) and development of strategies to prevent delays in daily operations. * **Quality Control and Risk Management**: Audit of case files and clinical notes to proactively detect errors, applying root cause analysis ($RCA$) and corrective action plans ($CAPA$). * **Cost Containment and Strategy**: Optimization of operational workflows and medical decisions that positively impact claim frequency, proposing innovations and automation within the process. * **High-Level Stakeholder Relations**: Direct intervention in critical or high-financial-impact cases, and serving as the technical liaison with VIP clients, brokers, and internal departments (Medical Networks, Direct Payment). * **Executive Communication**: Preparation and presentation of results reports, metric dashboards, and strategic proposals to senior leadership. **REQUIREMENTS AND QUALIFICATIONS** * **Bachelor’s Degree in Medicine** (degree and professional license required). * Minimum 5 years of insurance experience, with involvement across various adjudication areas (Direct Payment, Reimbursement, Scheduled Surgery, and/or Specialized Medical Management). * Experience negotiating with hospitals, reviewing account statements, and following up with providers. * Minimum 1 year of experience in GMM Claims Coordination and personnel management. * Personnel management (onboarding, offboarding, productivity and quality compliance). * Ensuring SLA compliance. * Developing KPIs to measure the impact of such improvements (Before/After). * Supervising documentation quality, clinical notes, justifications, and medical supporting documents generated by the team. * Designing continuous improvement strategies. * Communication with internal and external customers. * Use of AI technologies (preferred). * Microsoft Office: Advanced reporting (PivotTables and analytical procedures). * PowerPoint (to prepare executive presentations). **SPECIFIC REQUIREMENTS FOR INTERNAL CANDIDATES**: * You must have held your current position for at least 12 months. * Your most recent performance evaluation rating must be Satisfactory. * Your manager must be informed prior to your application. * We will request a confirmation email from you. * We recommend against applying to two or more processes simultaneously. **INTERPERSONAL PROFILE** * Leadership * Teamwork * Planning and organization of activities * Effective communication (with peers and other Claims areas) * Proactivity * Comprehensive analysis * Problem solving * Identification of root causes in key Claims opportunity areas * Commitment * Motivation Department: Operations \- Claims Manager: Montserrat Garcilazo/Guillermo García Schedule: Monday to Thursday, 8:30 AM to 5:30 PM; Friday, 8:30 AM to 3:30 PM. Work Model: 4 days in office, 1 day remote Location: Torre Manacar *At MetLife, we are committed to fostering diversity among employees through non-discriminatory treatment based on race, gender expression / gender identity, sexual orientation, religion, age, nationality, marital status, disability, physical or economic condition. HIV and pregnancy tests are not required for hiring, retention, or promotion, and equal employment opportunities are guaranteed.* We share the link to our Job Posting Policy, which outlines guidelines for job vacancy publications. **Benefits We Offer** Our benefits are designed to support your holistic well-being, with programs covering physical and mental health, financial wellness, and family support. We offer major medical expense insurance, life insurance, and a competitive compensation package that includes performance bonuses, a savings fund, and a pension plan. We also provide extended parental and adoption leave, plus additional benefits such as volunteer time off, birthday leave, Cultural Heritage Day, cultural and sports events — and much more! **About MetLife** Named to Fortune magazine’s 2025 “World’s Most Admired Companies” list and its 2025 “100 Best Companies to Work For™” list globally, 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. Our purpose is simple: to help our colleagues, customers, communities, and the world at large build a safer future. United by purpose and guided by our core values — Win Together, Do the Right Thing, Deliver Impact over Activity, and Think Future — we are inspired to transform the next century of financial services. At MetLife, it’s \#AllTogetherPossible — join us! At MetLife, we are committed to fostering diversity among employees, through non\-discriminatory treatment for reasons of gender, gender expression, sexual orientation, religion, age, nationality, marital status, disability, physical or economic condition, HIV and embarrassment as a requirement for entry, permanence or ascension and there is equal employment opportunities.