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Senior Long Term Care Claims Representative
Genworth Financial
Lynchburg, VA, United States
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POSITION TITLE
LTC Senior Claims Representative - Outgoing Eligibility (OE)
LOCATION
Lynchburg, VA
POSITION HOURS
This is a full-time, 40 hour/week position Monday - Friday
Potential shifts are: 7:30 - 3:30; 8:30 - 5:00; 9:30-6:00 (can select what works for you)
YOUR ROLE
This position is accountable for ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and responsible for the processing and payment of long-term care claims.
YOUR RESPONSIBILITIES
• The lead point of contact for the Insured or their legal representative, to provide the status of the eligibility review and set expectations as well as answer general status or payment questions
• Make claim payments based on the claimant's contract and other information provided at initial time of claim or ongoing payments through the claims life cycle as well as determining need for additional information to properly determine risk
• Effectively manage and prioritize a work queue and multiple job responsibilities in a fast-paced environment, frequently with aggressive deadlines
• Responsible for incoming and outgoing calls to claimants, caregivers, facilities and other persons or entities involved in the claim to enhance the customer experience
• Accountable for recognizing and working within a structured environment with clearly defined SOPs to ensure consistency of claims practices and resolution
• Other duties as assigned, including surge coverage for the call center as needed
YOUR QUALIFICATIONS
• Able to understand and interpret contract language, complex insurance laws, state legislative laws, disability processes, nursing home licensing and rehabilitative requirements
• Proven excellence in customer service which include: written and oral communication
• Experienced in using Windows applications (e.g. letter writing, spreadsheets, databases)
• Proven knowledge of medical terminology, anatomy and physiology, disease processes, medications and interpretation of lab results
• Ability to work independently and remotely
PREFERRED QUALIFICATIONS
• 18 – 24 months of experience in adjudicating ongoing Long Term Care claims
• Demonstrated understanding of single and cumulative medical conditions, including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential
• Demonstrated experience in making sound business decisions using risk management and quality protocols
• Bachelor's degree or higher
OUR COMPANY
Genworth Financial, Inc. is a leading insurance holding company committed to helping families achieve the dream of home ownership and address the financial challenges of aging through its leadership positions in mortgage insurance and long term care insurance. Headquartered in Richmond, Virginia, Genworth traces its roots back to 1871.
The mission of Genworth’s US Life business is to develop solutions that meet the financial challenges of aging, including individual and group long term care insurance, annuities, life insurance and new innovative products over time. We know we can’t deliver on our mission unless we deliver for our employees. That’s why we’re committed to creating a work environment that fosters inclusion, camaraderie, rewarding work, community involvement, and a focus on our employees’ well-being. We know each employee contributes in their own unique way and we’re dedicated to supporting every one of them to help them reach their full potential.