Long Term Care Claims Specialist
2 weeks ago
About Genworth Financial
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.
Core Values
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 Overview
As a key member of the Operations team, you will play a vital role in delivering exceptional customer service and capabilities to our policyholders. As a LTC Adjudication Specialist, your responsibilities will include making final determinations on complex adjudication decisions that positively impact the management of claims risk across the Genworth product portfolio. You will serve as a subject matter expert, working directly with Long Term Care claims associates to handle escalations and resolve complex claim issues. Additionally, you will contribute to the development of policies and practices while providing ongoing training.
Key Responsibilities
- Collaborate directly with Long Term Care claims associates to manage escalations and resolve complex claim issues.
- Review and finalize complex adjudication decisions that enhance claims risk management across the Genworth product portfolio.
- Participate in the development of policies and practices while providing continuous training.
- Assist in the creation, documentation, and maintenance of Claims Standard Operating Procedures.
- Conduct research and analysis regarding changes to Federal/State laws and regulations governing long-term care insurance and providers.
Qualifications
- A high school diploma or military experience.
- Ability to interpret, understand, and apply LTC policy language; capable of researching and analyzing complex state laws and regulations, particularly regarding long-term care provider licensing.
- Knowledge of long-term care insurance and the Medicare and Medicaid systems, along with an understanding of geriatric healthcare.
- Able to lead and participate in multiple projects from conceptualization through post-implementation while supporting other business units with competing priorities.
- Excellent written communication, facilitation, and presentation skills.
- Effective team player in a dynamic environment with a high degree of subjectivity and change.
- Exceptional customer service skills, demonstrating diplomacy and clarity in interactions with various stakeholders.
- Ability to integrate and accurately interpret risk management protocols in all decisions.
- Proven problem-solving and business analysis skills.
- Flexible and team-oriented, particularly in an evolving environment.
- Proficient in systems applications and analytical tools (e.g., WORD, EXCEL, PowerPoint).
Preferred Qualifications
- Unique knowledge and 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.
- Bachelor's degree or equivalent experience 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.
- Caregiver and Mental Health Support Services.
Compensation
The base salary pay range for this role starts at a minimum rate of $49,700 up to the maximum of $91,500. In addition to your base salary, you will also be eligible to participate in an incentive plan based on performance.
-
Long Term Care Claims Specialist
1 week ago
New York, New York, United States Genworth Financial Full timeAbout Genworth FinancialAt 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 our personal experiences as caregivers to our work, serving millions of policyholders each day.Our...
-
Long Term Care Claims Specialist
1 week ago
New York, New York, United States Genworth Financial Full timeCompany OverviewAt Genworth Financial, we empower families to confidently navigate the complexities of aging. Our mission is to provide compassionate support and innovative solutions tailored to the unique needs of our policyholders.Position SummaryThe LTC Adjudication Specialist plays a pivotal role within our Operations team, ensuring exceptional service...
-
CNA - Long Term Care Specialist
1 week ago
New York, New York, United States PRIDE Health Full timeCNA - Long Term Care SpecialistPRIDE Health is seeking a compassionate and skilled Certified Nursing Assistant (CNA) to provide high-quality, patient-centered care in a long-term care setting.Profession: Certified Nursing Assistant (CNA)Specialty: Long Term CareAs a CNA at PRIDE Health, you will have the opportunity to make a meaningful difference in the...
-
Travel Nurse RN Long Term Care Specialist
5 days ago
New York, New York, United States Medical Solutions Full timeJob Title: Travel Nurse RN Long Term Care SpecialistJob Summary: Medical Solutions is seeking a skilled Travel Nurse RN Long Term Care Specialist to join our team. As a Travel Nurse RN Long Term Care Specialist, you will provide high-quality patient care in a long-term care setting.Responsibilities:Provide direct patient care in a long-term care...
-
Managed Long Term Care Sales Specialist
1 week ago
New York, New York, United States MetroPlusHealth Full timeManaged Long Term Care Sales Specialist Category: Sales Department: Facilitated Enrollment Job Type: Regular Employment Type: Full-Time Compensation: $59,012.00 Empower. Unite. Care. MetroPlusHealth is dedicated to empowering New Yorkers by fostering community connections through quality care. We believe that healthcare is a fundamental right. If you possess...
-
Claims Support Specialist
2 weeks ago
New York, New York, United States Brighton Health Plan Solutions, LLC Full timeJob OverviewPosition SummaryThe Claims Support Specialist plays a vital role in managing care coordination and conducting utilization assessments by engaging in data gathering and entry. This position involves effective communication with Nurse Case Reviewers/Managers, healthcare providers, employers, and claimants regarding their workers' compensation...
-
RN Long Term Acute Care Specialist
1 week ago
New York, New York, United States Amergis Full timeJob SummaryAmergis is seeking a skilled Registered Nurse to join our team in a Long Term Acute Care setting. As a RN Long Term Acute Care Specialist, you will be responsible for providing high-quality patient care to medically complex patients.Key ResponsibilitiesDevelop and implement individualized patient care plans to meet the unique needs of each...
-
Managed Long-Term Care Sales Specialist
2 weeks ago
New York, New York, United States MetroPlusHealth Full timeJob OverviewEmpower. Unite. Care.At MetroPlusHealth, we are dedicated to empowering New Yorkers by fostering community connections through exceptional care. We believe that healthcare is a fundamental right. If you possess compassion and a collaborative mindset, consider joining our team. You can take pride in your contributions every day.About...
-
Travel Nurse RN Long Term Acute Care Specialist
17 hours ago
New York, New York, United States OneStaff Medical Full timeJob Title: Travel Nurse RN Long Term Acute Care SpecialistJob Type: Travel NursingLocation: York, PennsylvaniaJob Description:We are seeking a skilled Travel Nurse RN Long Term Acute Care Specialist to join our team at OneStaff Medical. As a Long Term Acute Care Nurse, you will provide high-quality patient care to individuals who require extended medical...
-
Senior Liability Claims Specialist
1 week ago
New York, New York, United States C. Winchell Agency, Inc. Full timeSenior Liability Claims SpecialistProperty & Casualty Insurance SectorLocation: NYCAs a Senior Liability Claims Specialist, you will be responsible for examining, adjusting, and defending general liability claims and lawsuits filed against insured parties, striving for amicable resolutions whenever feasible. Your role will involve:Reviewing the terms,...
-
Travel Nurse RN
5 days ago
New York, New York, United States Titan Medical (Nebraska) Full timeJob Title: Travel Nurse RN - Long-Term Care SpecialistJob Type: Per DiemLocation: NationwideJob Summary:Titan Medical (Nebraska) is seeking a skilled Travel Nurse RN to fill a Per Diem position in a Long-Term Care setting. As a Travel Nurse RN, you will provide high-quality patient care and support to residents in a dynamic and fast-paced...
-
New York, New York, United States Cross Country Nurses Full timeJob Title: Travel Nurse RN Long Term Acute Care SpecialistJob Summary: Cross Country Nurses is seeking a skilled Travel Nurse RN Long Term Acute Care Specialist to provide high-quality patient care in a dynamic and challenging environment.Responsibilities:Provide comprehensive nursing care to patients with complex medical conditions in a long-term acute care...
-
Local Contract Nurse RN
18 hours ago
New York, New York, United States HealthEcareers - Client Full timeAbout the JobHealthEcareers - Client is seeking a skilled Registered Nurse to join their team as a Long Term Care Specialist. This is a local contract nursing position that requires a strong background in long-term care and a passion for delivering high-quality patient care.Job ResponsibilitiesProvide direct patient care to residents in long-term care...
-
New York, New York, United States Gifted Healthcare Full timeJob SummaryWe are seeking a skilled Travel Nurse RN Long Term Acute Care Specialist to join our team at Gifted Healthcare. As a travel nurse, you will have the opportunity to work in a variety of settings and gain valuable experience in long-term acute care.Key ResponsibilitiesProvide high-quality patient care in a long-term acute care settingCollaborate...
-
Travel Nurse RN Long Term Care Specialist
1 week ago
New York, New York, United States PRN Healthcare Services Full timeAbout the JobWe are seeking a skilled Travel Nurse RN Long Term Care Specialist to join our team at PRN Healthcare Services.Provide high-quality nursing care to patients in a long-term care setting.Collaborate with healthcare teams to develop and implement patient care plans.Work weekends and nights (23:00-07:00) to ensure continuity of care.Contribute to a...
-
Insurance Claims Specialist
2 weeks ago
New York, New York, United States Collabera Full timeJob OverviewPosition Title: Insurance Claims SpecialistWork Arrangement: RemoteContract Duration: 7+ monthsCompensation: $18 - $20 per hourRole Summary:The Insurance Claims Specialist will be responsible for managing Travel Insurance Claims. An active adjuster's license from New York state is mandatory, and possessing licenses from multiple states is highly...
-
Eligibility Claims Specialist
7 days ago
New York, New York, United States City of New York Full timeJob SummaryThe City of New York is seeking a highly skilled Claims Review Specialist to join our team in the Revenue Office. As a Claims Review Specialist, you will be responsible for reviewing, processing, and determining potential SNAP benefit overpayments.Key ResponsibilitiesReview and process cases assigned manually or via Automated SNAP Claim System...
-
Claims Resolution Specialist
2 weeks ago
New York, New York, United States Catholic Health Service Full timeInsurance Billing & Claims Resolution SpecialistFacility: Catholic Health ServicesDepartment: Billing and Claims Follow-upCategory: Administrative / Business SupportSchedule: Full TimeShift: Day shiftHours: 8 AM - 4 PMPosition Overview: Under the supervision of the Physician Revenue Realization Manager, the Insurance Billing & Claims Resolution Specialist is...
-
Claims Management Specialist
2 weeks ago
New York, New York, United States City of New York Full timeBecome a vital member of our team at the City of New York and contribute significantly to the management of 1st Party No-Fault claims. As a Claims Management Specialist, your primary responsibility will be to oversee individual claims, authorize disbursements, manage arbitrations, process expenses, and more. Key Responsibilities: Oversee individual...
-
Claims Resolution Specialist
1 week ago
New York, New York, United States Catholic Health Service Full timeInsurance Billing and Follow-Up SpecialistFacility: Catholic Health ServicesDepartment: Billing and Claims ManagementCategory: Administrative SupportSchedule: Full TimeShift: Day ShiftHours: 8 AM - 4 PMPosition Overview: Under the supervision of the Physician Revenue Realization Manager, the Insurance Billing and Follow-Up Specialist plays a crucial role in...
