Claims representative Jobs in Philadelphia pa

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

Long Term Care Claims Representative – Payment Servicing

POSITION LOCATION

This position is available to 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.

SCHEDULED HOURS

During training, your hours will be 8 : 00 AM-5 : 00 PM EST. Once training is complete, your regular schedule will be 8 : 00 AM-5 : 00 PM EST. Schedule may adjust slightly in the future based on business needs. Candidates are expected to have consistent, reliable and predictable attendance during the duration of virtual classroom training and upon successful completion of training to support the needs of our customers.

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 by proactively providing accurate and timely information to ensure policyholders are fully informed during the claims process. You will, as a member of the Payment Servicing 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 across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and will be responsible for the processing and payment of long-term care 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, caregivers, facilities and other persons or entities involved in the claim to enhance the customer experience.

In support of our focus on ‘team’ vs ‘individual’, you will effectively manage and prioritize a work queue and multiple job responsibilities in a fast-paced environment, frequently with aggressive deadlines.

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 resolution. You will also be responsible for making complex decisions based on experience and sound judgment for situations not specifically defined in those procedures.

Collaboration and effective communication are important; you will seek solutions rather than just identify problems and will partner with teams across sites to achieve common goals.

You may occasionally be asked to help deepen others’ understanding of our processes and provide support as they grow in their role. This includes, but is not limited to, training / creating training material, side-by-side, group adjudication support, mentoring, and participating in buddy programs.

As part of our collaborative organization, you will provide insights, best practices, and share knowledge within Payment Servicing and to departments that support our teams such as QA, IT, Compliance, Eligibility and Contact Center.

Ability to handle inbound and outbound calls.

To support our customers and our business needs, you may be asked to do work outside of this role for periods of time; training and / or guidance will be provided if so.

Through the use of critical thinking and problem solving, you will make claim decisions and process transactions based on the claimant's policy and other information provided.

WHAT YOU BRING

You will spend the first several months of employment in virtual “classroom” training before beginning to phase into your job responsibilities. You will need to be on camera, actively participate in this training and must successfully complete all training requirements.

At Genworth, we are committed to caring for our customers and for the safety of our colleagues. When you are working remotely, or during inclement weather / other circumstances which may make the office inaccessible, high-speed internet (50 mbps) and a distraction-free area is required.

A high school diploma or military experience.

Excellent written and verbal communication skills with the ability to communicate information concisely and accurately.

Excel at customer service (minimum 1 year experience) as evidenced by professional and empathetic demeanor in all interactions

Proven ability to understand, interpret and comprehend contract language, disability processes, nursing home licensing and rehabilitative requirements

Exhibited competency in critical thinking, problem solving, conflict resolution and collaboration

Proficient with Microsoft Office applications (e.g., Word, Excel, Outlook, etc.)

Ability to toggle between multiple monitors for optimal and efficient productivity

Bachelor's or Associate degree preferred

Previous experience in the insurance industry 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

ADDITIONAL

The base salary pay range for this role starts at a minimum rate of $43,200 up to the maximum of $66,400. 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 5% 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.