Wisconsin Licensed Ombudsman Specialist

Job Summary

A company is looking for a LT Professional - Ombudsman Services Specialist.

Key Responsibilities

• Review, investigate, and resolve benefit-related complaints and inquiries from WRS participants
• Negotiate changes in benefit interpretations, policies, or practices with insurance plans and administrators
• Advise participants on grievance, appeals, and dispute resolution options when issues remain unresolved

Qualifications

• Knowledge of health insurance, life insurance, income continuation insurance, and WRS benefit programs
• Understanding of state and federal laws, rules, and regulations governing Medicare and Medicare supplement programs
• Ability to independently prioritize workload and make sound decisions after training
• Proficient use of computer applications for letters, spreadsheets, and reports
• Knowledge of interviewing, investigation, research, and data analysis methods