Active LTC Benefits Spec

Primary Duties and responsibilities Analyzes eligibility for and approves or denies the payment of active long-term care claims (analyzes and processes client bills, establishes new independent providers, prepares for annual review, and other transactions applicable to active claims).Assist in determining provider eligibility as it relates to individual insureds’ plan of care by gathering information about the insured’s medical function and cognitive status.Determines applicability of benefits claimed by interpreting state and contract variations.Responds to questions from incoming insureds or representative’s phone calls and emails regarding requests for information needed for ongoing long term claim administration Communicates both verbally and in writing with Insureds and their representatives, Field Force, medical practitioners and related service providers, attorneys, other insurance companies, and divisional resources which involve negotiation and conflict resolution.Preserves Northwestern Long Term Care's image and reputation in the approval or denial of benefits despite difficult and delicate circumstances.May be called upon for project and committee work as a Subject Matter Expert (SME), including the development of process improvements.Update standard work as requested.Support co-workers to meet the goals of the team and division.Discuss any identified process improvements ideas with leadership to determine feasibility.This role involves managing a queue of incoming phone calls, which includes direct client interactions a minimum of 16 hours per week.

Skills, Experience, Qualifications, If you have the right match for this opportunity, then make sure to apply today.

Qualifications Healthcare background desirableBachelor's degree or equivalent combination of education and work experience will be consideredExperience with Long Term Care or insurance claims desirableStrong written and verbal communication skills requiredStrong technology skills requiredDemonstrated initiative and strong support of team resultsHigh degree of analytical skills, personal organization, and time managementStrong client focus and customer service skillsAbility to deal with ambiguity and maintain a positive outlook in the face of changeAbility to identify process improvement opportunities.

Compensation Range: Pay Range - Start: $48,580.00 Pay Range - End: $90,220.00 Geographic Specific Pay Structure: Structure 110: Structure 115: We believe in fairness and transparency.

It’s why we share the salary range for most of our roles.

However, final salaries are based on a number of factors, including the skills and experience of the candidate; the current market; location of the candidate; and other factors uncovered in the hiring process.

The standard pay structure is listed but if you’re living in California, New York City or other eligible location, geographic specific pay structures, compensation and benefits could be applicable, click here to learn more.

Grow your career with a best-in-class company that puts our clients' interests at the center of all we do.

Get started now! Northwestern Mutual is an equal opportunity employer who welcomes and encourages diversity in the workforce.

We are committed to creating and maintaining an environment in which each employee can contribute creative ideas, seek challenges, assume leadership and continue to focus on meeting and exceeding business and personal objectives.

Skills Problem Management (NM) - Intermediate, Prioritization (NM) - Intermediate, Empathetic Communication (NM) - Intermediate, Insurance Acumen (NM) - Beginner, Customer Centricity (NM) - Intermediate, Insurance Contract Management (NM) - Beginner, Analytical Thinking (NM) - Intermediate, Adaptive Communication (NM) - Intermediate, Learning Agility & Critical Thinking (NM) - Intermediate, Information Gathering (NM) - Beginner, Decision Making (NM) - Intermediate, Attention to Detail (NM) - Intermediate, Change Adaptability (NM) - Intermediate, Data Application (NM) - Beginner FIND YOUR FUTURE We’re excited about the potential people bring to Northwestern Mutual.

You can grow your career here while enjoying first-class perks, benefits, and our commitment to a culture of belonging. xmvmafu

Flexible work schedulesConcierge serviceComprehensive benefitsEmployee resource groupsPandoLogic.

Keywords: Compensation / Benefits Specialist, Location: Franklin, WI - 53132