Determines the applicability of benefits claimed by interpreting contract provisions, state regulations, and uses claim knowledge in interpreting and analyzing facts to reach claim decisions on new and continuing claims. Orders and reviews appropriate medical, investigative, service provider, and other information needed to determine eligibility of long-term care claims.
Requirements
- Registered Nurse or Social Work license
- Healthcare background or minimum 3+ years of long-term care insurance experience
- Bachelor's degree or equivalent combination of education and work experience
- Strong written and verbal communication skills
- Strong technology skills
- Demonstrates initiative and strong support of team results
- High degree of analytical skills, personal organization, and time management
- Strong client focus and customer service skills
- Ability to deal with ambiguity and maintain a positive outlook in the face of change
- Ability to identify process improvement opportunities
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Retirement plan
- 401(k) matching
- Paid time off
- Life insurance
