Associate Claims Clinical Specialist

Associate Claims Clinical Specialist

Join us on a mission to simplify and dignify the aging experience. We are the children, siblings, neighbors, and friends of those navigating the fragmented and confusing system of long-term care. Our team is ferociously curious and relentless in our pursuit of a better system – and we are deeply committed to a sense of belonging for all, in all phases of life. We're creating a new experience for care seekers and their families, bringing together long-term care options, non-healthcare resources, education, and human support into one place. We work hard, we have fun, we care about each other, and we share the mission. If this sounds like a place where you could thrive, join us! CareScout is a wholly owned subsidiary of Genworth Financial, Inc, a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging.

Location: This position is available to remote applicants residing in the US. Hybrid in-office would be required if you reside within 50 miles of a Genworth | CareScout office.

Your Role

The position of Associate Claims Clinical Specialist plays a leading role in the insured or member's assessment process. We provide services to a variety of clients, all that require your deep knowledge of long-term care needs of an aging or chronically ill population. You will be part of a remote team of clinicians that spend their days reviewing clinical assessments completed by field assessors and writing Plans of Care for Long Term Care Insurance and other government sponsored insurance plans. Some days will be spent reaching out to claimants or members, their families, or facilities to discuss updates to their health and develop a plan of care. As our client list and capabilities grow, our opportunities also grow.

This position uses your eldercare expertise and excellent communication skills to assure that the company serves our clients with the highest degree of quality, respect, and customer service. The successful candidate must be caring and empathetic with claimants, members, and their families.

What You Will Be Doing

• Reviewing clinical assessments completed by field assessors to determine chronic illness status and develop a plan of care with supporting written documentation.
• Collaborate with field assessors and facility staff via phone to determine if further information is needed on a claimant or member's health status
• Call claimants, family members or facility staff to update records on their present health status and provide a new plan of care, as well as handle telephonic assessments
• Work with new clients to develop processes that meet their insureds' needs.

What You Bring

• RN with a current license residing in a Nursing License Compact state with licensure in their residential state and a Nursing Compact License
• A minimum of 3 years of professional clinical experience in case management, home care, or a rehabilitation setting, preferably with a geriatric population
• Strong knowledge of Microsoft applications to include Outlook and Word. Proficient with workflow management tools and CRM
• Ability to data input into a digital platform while discussing care needs with a claimant or member
• Ability to handle inbound and outbound calls with claimants, family members, facilities and agencies
• Excellent communication skills, both oral and written, with a customer service focused attitude to build rapport and relationships
• Ability to meet daily tracked standards in both production and quality.
• Excellent computer, data input and technical skills including working with multiple screens.
• Demonstrate technical and professional expertise through problem resolution, while maintaining composure. Ability to effectively communicate with both internal and external customers at all levels
• Robust critical thinking capabilities, coupled with the ability for independent decision making
• Strong multi-tasking, time management and follow-up skills to complete tasks in time sensitive manner
• Ability to independently resolve service issues and follow escalation protocol on issues
• Ability to make positive impressions over the phone and build rapport with clients, despite conversations that can be difficult or emotion filled
• Ability to work remotely in a quiet environment with strong, reliable internet while maintaining production levels

Nice to have:

• BSN or equivalent
• Knowledge of Long-Term Care settings and residents
• Previous experience with Long Term Care, Medicare, or Medicaid Assessments
• Telephonic case management experience
• Bilingual

Additional Information:

National Range: $55,800-81,000

High-Cost Range (includes New York): $55,800-107,500

Disclaimer: This role is aligned to a national market-based pay range. Actual compensation will vary based on geographic location, experience, skills, and other job-related factors. In addition to base salary, this role is eligible to participate in a bonus incentive plan. Incentive compensation is based on individual and company performance and is not guaranteed.

Employee Benefits & Well-Being Genworth/CareScout 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