LTC Adjudication Specialist - Lincolnwood Illinois

Company: VirtualVocations
Location: Lincolnwood, Illinois
Posted On: 04/05/2025

A company is looking for a LTC Adjudication Specialist responsible for complex adjudication decisions in long-term care claims.
Key Responsibilities

Partner with Long Term Care claims associates to handle escalations and resolve complex claim issues
Review and finalize complex adjudication decisions impacting claims risk management
Develop policies, practices, and provide ongoing training related to claims operations

Required Qualifications

Ability to interpret and apply long-term care policy language and state regulations
Knowledge of long-term care insurance, Medicare, and Medicaid systems
Experience leading projects and supporting multiple business units
Bachelor's degree or equivalent experience preferred
4-5 years of experience in an allied health profession, insurance, or legal background is a plus More...

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