Long Term Care Benefit Claim Specialist
Mutual Of OmahaPuerto Rico, United States
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Responsible for the accurate and timely evaluation, management, and adjudication of Long Term Care claims from initial notification through claim resolution. This role involves analyzing medical, contractual, and vocational information to determine eligibility for benefits, making informed decisions on claim approvals or denials, and ensuring compliance with internal policies and regulatory requirements. The position requires effective communication with claimants, employers, and medical professionals while delivering a high-quality customer experience and supporting financial performance and customer retention. You must have current working experience with Long Term Care specific claims adjudication.