Associate LTC Claims Specialist

At Genworth, we empower families to navigate the aging journey with confidence. We are compassionate, experienced allies for those navigating care with guidance, products, and services that meet families where they are. Further, we are the spouses, children, siblings, friends, and neighbors of those that need care—and we bring those experiences with us to work in serving our millions of policyholders each day. 

We apply that same compassion and empathy as we work with each other and our local communities, Genworth values all perspectives, characteristics, and experiences so that employees can bring their full, authentic selves to work to help each other and our company succeed. We celebrate our diversity and understand that being intentional about inclusion is the only way to create a sense of belonging for all associates. We also invest in the vitality of our local communities through grants from the Genworth Foundation, event sponsorships, and employee volunteerism.

Our four values guide our strategy, our decisions, and our interactions:

• Make it human. We care about the people that make up our customers, colleagues, and communities.

• Make it about others. We do what’s best for our customers and collaborate to drive progress. 

• Make it happen. We work with intention toward a common purpose and forge ways forward together. 

• Make it better. We create fulfilling purpose-driven careers by learning from the world and each other.

POSITION TITLE

Associate LTC Claims Specialist

POSITION LOCATION

This position is available to Virginia residents as Richmond or Lynchburg, Virginia in-office applicants or remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin.

YOUR ROLE

As an Operations team member, you’ll play a crucial role in delivering world class customer service and capabilities to our policyholders—now and in the future. This is an opportunity to support both our business needs and customer centric culture by utilizing investigative, critical-thinking and communication skills. As a LTC Associate Long Term Care Claims Specialist you will make sound and accurate Eligibility determinations based on a thorough review of information from various sources, including, but not limited to, a Policyholder’s contract and clinical assessment(s), or seek additional information as needed to properly assess risk and resolve discrepancies. Additionally, you will participate in developing policies and practices.

What you will be doing

• Obtaining and evaluating information required to accurately, timely and objectively adjudicate Initial and/or Ongoing LTC Eligibility claims

• Carrying out a planned, comprehensive and detail-driven analysis of all information available in order to confirm eligibility for benefits

• Proactively requesting additional information as needed from policyholders, family members or care providers to solve for any inconsistencies

• Conducting caring customer outreach to discuss findings or to explain policy requirements

• Identifying cases that require a higher level of review, or would benefit from further consultation, such as those with threshold cognitive or functional impairment

• Working within a structured environment with established Standard Operating Procedures to ensure consistency of claims practices

• Through a focus on communication, teamwork and collaboration, partnering with other teams or departments to achieve common goals and support continuous improvement initiatives

• You will be expected to have consistent, reliable and predictable attendance to support the needs of the business

What you bring

• At least 2 years claims adjudication, paralegal or equivalent experience

• Ability to work an 8-hour day of scheduled hours beginning no later than 9:00 am EST and ending no earlier than 3:30 pm EST. This is subject to change in the future should the business needs change.

• Ability to understand and interpret contract language, complex insurance laws or state legislative laws and privacy rules

• Understanding of single and cumulative medical conditions or disease processes, including their prognosis, rehabilitative potential, and effect on physical or cognitive function

• Excellent written and verbal communication skills, including proficiencies in documenting and presenting, in order to provide top quality external customer service and effectively collaborate with other internal business areas

• Exceptional time management, organizational skills and flexibility to adapt to change and successfully manage a challenging workload and competing priorities.

• Proven competency in critical thinking, problem solving and conflict resolution

• Possess a strong interest in learning new tasks and taking initiative to support and assist others, which may include mentoring, shadowing, group adjudication support, etc.

• Professional and positive mindset, taking ownership of work product, with an ability to work both independently and be an effective team player

• Proficient knowledge of system applications (Microsoft Office applications - e.g., letter writing, spreadsheets, etc.)

• Ability to toggle between multiple monitors for optimal and efficient productivity

• Able to interact effectively with all associate levels, while maintaining professionalism

Nice to have

• 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 preferred

• Bachelor’s degree or equivalent experience preferred

• Proficient knowledge of claims and workflow systems

Employee Benefits & Well-Being

Genworth employees make a difference in people’s lives every day. We’re committed to making a difference in our employees’ lives. We offer competitive benefits including:

• Medical, Dental, Vision, Flexible Spending Account options beginning your first day  

• Generous Choice Time Off your first full year

• Generous Paid Time Off – Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave

• Disability, Life, and Long-Term Care Insurance

• 40 hours of volunteer time off

• 401K Account with matching contributions

• Tuition Reimbursement and Student Loan Repayment and Training & Certification Support

• Paid Family Leave

• Child Care Subsidy Program

• Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management)

• Caregiver and Mental Health Support Services

ADDITIONAL
The base salary pay range for this role starts at a minimum rate of $50,100 up to the maximum of $85,600. In addition to your base salary, you will also be eligible to participate in an incentive plan. The incentive plan is based on performance and the target earning opportunity is 7% of your base compensation.  The final determination on base pay for this position will be based on multiple factors at the time of this job posting including but not limited to geographic location, experience, and qualifications to ensure pay equity within the organization.