What are the responsibilities and job description for the Senior Claims Representative - LTC Claims Intake position at Genworth North America Corporation?
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
Senior Claims Representative - LTC Claims Intake
POSITION LOCATION
This position is available to Virginia residents as Richmond or Lynchburg, Virginia hybrid 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. Long Term Care Claims is transforming and with transformation comes the potential for constant change. You will support our customer centric culture as a customer advocate by guiding our customers through the benefit eligibility requirements for their specific policy and proactively provide intricate policy details for our customers to be fully informed at the start of the claims process. You will, as a member of the Intake Team, partner closely with the Eligibility and Contact Center teams to provide an extraordinary claims experience for our customers. You will work in a fast-paced environment with an in-depth knowledge of all products, ensuring our customers have been thoroughly educated to their policy provisions and together a determination is made for how to proceed. You will follow internal guidelines, Compliance requirements and will be responsible for the processing and opening of claims. We operate daily with integrity and character to achieve outstanding results.
What You Will Be Doing
To ensure excellence in our relationship with our customer, you will be responsible for incoming and outgoing calls to claimants, family members, facilities and other persons or entities involved in the initial claim set-up to enhance the customer experience.
You will be accountable for ensuring our callers leave the Intake conversation with an understanding of their policy coverage and benefit eligibility guidelines/status.
Collaboration and effective communication are an important piece of the Intake role. You will gather recent events bringing the insured to claim along with any pertinent medical diagnoses and assist in finding quality care through CareScout Quality Network.
This information will be entered into the Pega system with additional documentation to provide an overview of the initial phone conversation. This information is helpful to the eligibility team and our vendors.
Through the use of critical thinking skills and problem solving, you will analyze the information provided by the caller and make decisions about reasonable expectations of benefit eligibility and obtain a mutual agreement from the applicable caller for how to proceed.
You will be accountable for recognizing and working within a structured environment with clearly defined Standard Operating Procedures, to ensure consistency of claims practices and Notice of Claim initiation.
You will be expected to have consistent, reliable and predictable attendance to support the needs of the business.
You are able to work a shift of 9:30am EST – 6:00pm EST to ensure we have the appropriate amount of coverage for our customers. This is subject to change in the future should the business needs change.
What You Bring
Minimum 1 year Long Term Care Claims or Customer Service experience; medical, disability, or worker’s compensation experience preferred
You excel in customer service as evidenced by professional and empathetic demeanor in all interactions
Your work exhibits these qualities: critical thinking, problem solving, conflict resolution and collaboration
Due to experience or education, you possess knowledge of medical terminology and diseases/diagnoses and are able to understand and interpret contract language, disability processes, nursing home licensing and rehabilitative requirements
Proficiently navigate throughout Pega
Medicare/HIPAA experience preferred
Associate or bachelor’s Degree preferred
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.
Competitive Compensation & Total Rewards Incentives
Comprehensive Healthcare Coverage
Multiple 401(k) Savings Plan Options
Auto Enrollment in Employer-Directed Retirement Account Feature (100% employer-funded!)
Generous Paid Time Off – Including 12 Paid Holidays, Volunteer Time Off and Paid Family Leave
Disability, Life, and Long Term Care Insurance
Tuition Reimbursement, Student Loan Repayment and Training & Certification Support
Wellness support including gym membership reimbursement and Employee Assistance Program resources (work/life support, financial & legal management)
Caregiver and Mental Health Support Services
