Long Term Care Claims Representative – Payment Servicing

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. We bring personal experiences as spouses, children, siblings, friends, and neighbors of those who need care to our work, serving millions of policyholders each day. We value all perspectives, characteristics, and experiences, fostering an inclusive environment where employees can bring their full, authentic selves to help each other and the company succeed. We invest in local communities through grants, event sponsorships, and employee volunteerism. Our four values guide our strategy, decisions, and interactions: Make it human, Make it about others, Make it happen, and Make it better.

About the role

As an Operations team member, you’ll play a crucial role in delivering world-class customer service and capabilities to our policyholders. You will support our customer-centric culture by proactively providing accurate and timely information to ensure policyholders are fully informed during the claims process. As a member of the Payment Servicing Team, you will partner closely with the Eligibility and Contact Center teams to provide an extraordinary claims experience. You will work in a fast-paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements. You will be responsible for the processing and payment of long-term care claims, operating daily with integrity and character to achieve outstanding results.

Schedule

During training, your hours will be 8:00 AM–5:00 PM ET. Once training is complete, your regular schedule will remain 8:00 AM–5:00 PM ET, with potential slight adjustments based on business needs. Candidates must have consistent, reliable, and predictable attendance during virtual classroom training and after training to support customer needs.

While working remotely, you must provide a safe and secure workspace free of distractions and maintain a stable, high-speed internet connection (50 mbps or higher). Employees are required to be on camera during all training sessions, meetings, and as needed per request.

Responsibilities

• Manage and prioritize a work queue and multiple responsibilities in a fast-paced environment with aggressive deadlines.
• Adhere to Standard Operating Procedures to ensure consistency in claims practices and resolution.
• Make complex claim-payment decisions based on knowledge and policy provisions.
• Apply critical thinking and problem-solving skills to adjudicate claims, process transactions, and payments.
• Interact with policyholders, powers of attorney, agents, facilities, and other entities via incoming and outbound calls.
• Collaborate and communicate effectively, seeking solutions rather than just identifying problems, and partner with teams across sites to achieve common goals.
• Occasionally provide training and support to others, including creating training materials, mentoring, and participating in buddy programs.
• Share insights, best practices, and knowledge within Payment Servicing and with supporting departments such as QA, IT, Compliance, Eligibility, and Contact Center.
• Maintain flexibility to perform tasks outside of the role as needed, with provided training and guidance.
• Participate in virtual classroom training for the first several months, actively engaging and completing all training requirements.

Requirements

• Minimum High School Diploma.
• Minimum 2 years’ experience in providing professional customer service, preferably in a corporate setting such as medical, financial, or specifically in Long Term Care.
• Exceptional communication skills, both written and oral.
• Demonstrated qualities such as critical thinking, problem-solving, conflict resolution, and collaboration.
• Knowledge of medical terminology, diseases/diagnoses, and the ability to understand and interpret contract language, disability processes, nursing home licensing, and rehabilitative requirements.
• Proficient with Microsoft Office applications (e.g., Word, Excel, Outlook, PowerPoint, Teams).
• Ability to toggle between multiple monitors for optimal and efficient productivity.
• A dedicated, distraction-free home office setup, including a desk or workstation suitable for full-time remote work.

Qualifications

Nice to Have:

• Previous experience in the insurance industry.
• Associate or Bachelor’s Degree.
• Familiarity with HIPAA requirements.

Benefits

• Competitive compensation and total rewards incentives.
• Comprehensive healthcare coverage.
• Multiple 401(k) savings plan options, including auto-enrollment in an employer-directed retirement account (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.

Pay

High-Cost Range (includes New York): $56,900–$83,000

National Range: $45,500–$66,000

Actual compensation will vary based on geographic location, experience, skills, and other job-related factors. This role is eligible to participate in a bonus incentive plan based on individual and company performance, though incentive compensation is not guaranteed.

This position is not eligible for sponsorship.