Genworth Financial Special Investigations Unit Specialist in Richmond, Virginia

POSITION

Special Investigations Unit Specialist

LOCATION

Richmond or Remote (Virginia)

COMPANY

Genworth is a Fortune 500 financial services company providing financial security and protection through our Mortgage Insurance and US Life Insurance businesses. Our purpose is to help families achieve the dream of homeownership and address the financial challenges of aging. At Genworth, our promise to our employees is the opportunity to make a meaningful difference in the lives of our customers, our communities, and one another.

The mission of Genworth’s US Life business is to develop solutions that meet the financial challenges with the aging, including individual and group long term care insurance, annuities, life insurance and new innovative products over time.

POSITION SUMMARY

This position will provide support for the Special Investigations Unit (SIU) in the prevention, detection, investigation, mitigation and reporting of Long Term Care fraud and abuse. Specifically, this person will:

  • Identify suspect long term care (LTC) claims and coordinate information for investigations

  • Provide support for SIU Manager and other SIU team members as well manage SIU calendar and process inbox

  • Cross train on other products to provide support for suspect insurance transactions referred by fraud response unit or other areas of the business

RESPONSIBILITIES

  • Develop and implement strategies and tactics to prevent and reduce fraud and the identification, investigation and prosecution of all fraudulent activities

  • Data mine for suspicious claims for SIU investigators including set up in LIMS & Calypso

  • Investigate suspicious and/or unusual claims, which may include calling or writing insureds, caregivers, etc as well as conducting internet research

  • Serve as a resource to provide consulting, training and feedback to the claims department

  • Establish investigative strategies by thinking critically and analytically and exercising sound judgment

  • Provide day-to-day support for field investigators

  • Provide support and backup of the processing of SIU expenses related to surveillance vendors

  • Attend trade conferences and compliance seminars annually to stay current on fraud and compliance issues

  • Know and uphold the provisions of the Corporate Fraud Plan

  • Perform special projects and other job-related duties as requested by the SIU Manager with reasonable accommodations

REQUIRED QUALIFICATIONS

  • Bachelor's degree or equivalent work experience

  • At least five years of experience in insurance with a strong and proven investigative intuition and prowess

  • Advanced level of experience in Microsoft Office Applications (e.g., Excel, Word and PowerPoint)

  • A proven track record for identifying suspicious insurance transactions

  • Critical listening and analytical thinking skills

  • Attention to detail with customer service orientation

  • Strong problem solving and decision-making skills

  • Excellent communication skills (written and verbal), including the ability to understand and write complex legal documents

  • Ability to work independently and within a team environment to accomplish common goals

PREFERRED QUALIFICATIONS

  • Strong institutional knowledge

  • Claims, life insurance and/or annuity experience

  • A demonstrated ability to recognize red flags and the understanding of the SIU process

  • Experience with Calypso, eProcess, SuperClue and policy admin systems

Genworth Financial, Inc. is a leading insurance holding company committed to helping families achieve the dream of home ownership and address the financial challenges of aging through its leadership positions in mortgage insurance and long term care insurance. Headquartered in Richmond, Virginia, Genworth traces its roots back to 1871.