LTC Adjudication Specialist

Company	Genworth Financial
Location	Kansas, USA, Pennsylvania, USA, North Dakota, USA, Delaware, USA, Iowa, USA, Washington, DC, USA, Texas, USA, Lynchburg, VA, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, South Carolina, USA, Richmond, VA, USA, South Dakota, USA, Georgia, USA, Concord, NH, USA, Arlington, VA, USA, Mississippi, USA, Tennessee, USA, Virginia, USA, Arkansas, USA, Minnesota, USA, Nebraska, USA, Rhode Island, USA, Kentucky, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, Wisconsin, USA, Maine, USA, Massachusetts, USA, North Carolina, USA, Oklahoma, USA, Missouri, USA, Ohio, USA, Indiana, USA, Louisiana, USA, Michigan, USA, Illinois, USA, Alabama, USA
Salary	$58800 – $102500
Type	Full-Time
Degrees
Experience Level	Mid Level, Senior

Must be able to interpret, understand and apply LTC policy language; Able to research, analyze and interpret complex state laws and supporting regulations, most specifically regarding the licensing of long-term care providers
Knowledge of long term care insurance and the Medicare and Medicaid systems
Knowledge of geriatric health care including long-term care, knowledge of anatomy, symptomology and physiology and how these translate to prognoses, diagnoses and treatment plans
Able to lead and/or participate in multiple projects from conceptualization through post implementation in addition to providing support to other business units with competing priorities
Superior written, verbal communication, and presentation skills
Works effectively in a team environment that presents a high degree of subjectivity and change
Superior customer service skills demonstrating diplomacy, clarity and influence in working with other areas of the business, vendors, policyholders and sales force
Integrates and accurately interprets risk management protocol in all decisions
Proven problem-solving and business analysis skills
Team oriented and flexible to change, particularly in an on-going change environment
Able to interact effectively with all associate levels, while maintaining professionalism
Good working knowledge of systems applications and analytical tools (e.g. WORD, EXCEL, PowerPoint, etc.)

Partnering directly with Long Term Care claims associates as the subject matter expert in adjudication handling escalation and resolution of risk decisions and complex claim problems
Review and final determination of complex adjudication decisions whose outputs will have a positive impact on the management of claims risk across the Genworth product portfolio
Participates in developing policies and practices providing ongoing training
Assisting in the development, documentation, and maintenance of Claims Standard Operating Procedures
Research, analysis, and communication of any changes to the Federal/State laws and regulations governing long-term care insurance and long-term care providers

Unique knowledge & skills typically acquired by experienced disability and/or worker compensation claims examiners specializing in LTC, LTD or ID claims, and/or 4-5 years of experience in an allied health profession, insurance industry, or legal background
Bachelor’s degree or equivalent experience