Long Term Care Claims Representative

Job Summary

As a full-time Long Term Care Claims Representative specializing in Payment Servicing, the candidate will manage and prioritize claims processing and payment tasks in a fast-paced environment while providing exceptional customer service to policyholders remotely or from designated locations in Virginia.

Key responsibilities

• Manage a work queue and process long-term care claims while adhering to standard operating procedures
• Make complex claim-payment decisions based on policy provisions and apply critical thinking to adjudicate claims
• Collaborate with various teams and communicate effectively with policyholders and related entities throughout the claims experience

Required qualifications

• Minimum High School Diploma
• At least 2 years of professional customer service experience, preferably in a medical or financial setting
• Knowledge of medical terminology and the ability to interpret contract language related to long-term care
• Proficiency in Microsoft Office applications
• A dedicated, distraction-free home office setup suitable for full-time remote work