Wellcove/CHCS-Services logo

Wellcove/CHCS-Services

Remote Jobs

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

22 open rolesTeam 1001-5000Latest: Jul 29, 2026, 6:00 AM UTC
Insurance
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Minimum Salary
Experience

22 Jobs

Wellcove/CHCS-Services logo

Claims Support Associate

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This position is responsible for the administrative support duties of most levels of claims in accordance with policy, company, state, and federal guidelines. This position is for Long Term Care Insurance Plans administered by Prudential. - Interact professionally with other business units to gather and analyze data needed to properly adjudicate claims and documentation of claims files. - Review requests involving Power of Attorney, Guardianship and Authorizations to Release Information. - Assist the Claims team in requesting medical documentation to adequately adjudicate long-term care eligibility. Reviewing the documents received to determine if complete and accurate. - Assist Claims Management with assigning work activities to associates within our workflow. - Respond professionally and timely to customer inquiries. - Ensure service calls are made in a timely, efficient and knowledgeable manner. - Follow up on any outstanding documentation with additional correspondence, reviewing fax failures, and reviewing any returned mail. - Contact providers and customers to obtain accurate contact information. - Maintain current knowledge of federal, state, and insurance regulations and requirements. - Maintain working knowledge of all company and services pertaining to business segment. - Maintain working knowledge and proficiency in company claims and administrative software systems as well as Microsoft applications. - Maintain client and company quality and production standards. - Maintain knowledge of applicable company policies and procedures. - Operate within company regulations regarding HIPAA, fraud, confidentiality, and private health information. - Other duties may be assigned. Qualifications - High School diploma required. - Previous experience in the Long-Term Care insurance industry and/or administrative preferred but not required. Requirements - Ability to read, analyze, and interpret complex documents. - Ability to respond effectively to the most sensitive inquiries or complaints. - Ability to write policies and procedures. - Ability to make effective presentations. - Excellent verbal and written communication skills. - Customer Service; Work Standards; Decision-Making; Communication; Interpersonal Skills; Integrity/Honesty and Adaptability/Flexibility. - Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. - Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. - Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. - Ability to deal with problems involving several concrete variables in standardized situations. Physical Requirements - Frequently required to sit; use hands to finger, handle, or feel; and talk or hear. - Occasionally required to stand; walk; reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. - Must occasionally lift and/or move up to 10 pounds. - Specific vision abilities required include close vision, distance vision, color vision, and ability to adjust focus. Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

Enrollment Specialist

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description The Electronic Visit Verification (EVV) and Facility Enrollment Specialist is responsible for facilitating the enrollment of insureds who receive home care and facility services from provider agencies, independent caregivers, and facilities into the EVV and/or Facility program. This position primarily conducts outbound and inbound telephone outreach to educate stakeholders, guide them through the enrollment process, resolve questions, and ensure all enrollment requirements are completed accurately and timely. The ideal candidate possesses strong communication, customer service, and organizational skills, with the ability to effectively manage multiple cases while maintaining compliance with applicable state, federal, and program requirements. - Conduct high-volume outbound and inbound phone calls to insureds, provider agencies, caregivers, and independent providers regarding EVV enrollment. - Educate callers on EVV program requirements, enrollment procedures, deadlines, and available support resources. - Guide stakeholders through the enrollment process, ensuring all required information and documentation are obtained. - Assist providers with complete enrollment forms, account setup, and system access. - Verify enrollment information for accuracy and completeness. - Document all customer interactions, enrollment activities, and case notes in the appropriate systems. - Follow up with insureds and providers to obtain missing information and ensure timely completion of enrollment. - Respond professionally to questions, concerns, and enrollment issues while providing exceptional customer service. - Coordinate with internal departments and external partners to resolve enrollment-related issues. - Monitor assigned enrollment cases and meet established productivity, quality, and service-level expectations. - Maintain confidentiality of protected health information (PHI) and comply with HIPAA and all applicable state and federal regulations. - Stay current on EVV program requirements, policies, and system updates. - Build and maintain strong client relationships to ensure satisfaction and compliance with EVV requirements. - Provide training and guidance to clients on the use of EVV and Facility platforms, tools, and processes. - Gather required information from claimants and caregivers and accurately record data in Wellcove’s platforms/systems. - Maintain organized documentation for all client interactions, training sessions, and compliance activities. - Provide outstanding customer service via phone and email, displaying professionalism, empathy, a sense of urgency, and a genuine willingness to help. - Independently process caller requests accurately and promptly in Wellcove’s proprietary system and escalate as appropriate. - Comply with customer support objectives and performance standards. - Effective use of process resources to gain knowledge base and ensure the delivery of accurate information and error-free processing of requests. - Willingness to learn new duties and technology-related skills as required. Qualifications - Proficiency with Microsoft office applications, Nitro, and the ability to learn multiple software applications. - Accountable and able to work remotely and independently. - Displays a positive ‘can do’/customer-first attitude. - Ability to accurately document customer responses while simultaneously speaking with customers. - Excellent communication skills and appropriate etiquette, great phone manners, and ability to speak with a wide range of personalities. - Demonstrate a high level of proficiency in the use of the English language in oral and written forms. - Collaborative team spirit. - Ability to explain complex processes in a clear and easy-to-understand manner. - Knowledge of HIPAA privacy requirements and confidentiality standards. - Ability to meet performance metrics related to call volume, quality, and enrollment activation. - Must have a dedicated remote work location free from background noises, interruptions, and desk clutter. - Must have reliable internet connection and access to a smart phone. Education and Experience - High School or GED required. - Bachelor’s Degree, or equivalent combination of education, training, and experience preferred. Physical Requirements - Sedentary work. Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers. - Primarily remote call-center environment. - Extensive telephone communication throughout the workday. - Frequent computer use for documentation and enrollment processing. - May require occasional overtime based on program or enrollment deadlines. Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

Customer Service Representative 1

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This job provides customer service in a call center environment by primarily receiving and responding to telephone inquiries from policyholders, beneficiaries, providers, agents, or others for information concerning insurance policies by performing the following duties: - Provides information and assistance to providers, agents, policyholders, and others by responding to telephone inquiries from CHCS third-party administrator clients to include Medicare Supplement and Life Policies. - Accurately provide information regarding various insurance questions (i.e., verification of benefits, claims status) by accessing and updating software system data within company response standards. - Provides service and follow-up on insurance questions by researching company records to obtain information requested by customers, performing routine transactions, and retrieving results from an online terminal. - Maintains working knowledge base of all company products and services. - Complying with company regulations regarding Privacy, confidentiality, and private health information. - Providing written and oral communication to policyholders, agents, providers, and others regarding inquiry status and resolution. - Initiate and complete Call Tracks, checklists, and supportive clerical responsibilities as necessary. - Ability and Flexibility to work various shifts as required. - Able to type speed of 30 wpm with 95% accuracy rate. Qualifications - High school diploma or general education degree (GED); and six months related call center experience and/or training. - Associate's degree preferred. - Experience with Long Term Care Insurance preferable in a Call Center setting. - 2 years related call center and customer service experience. Requirements - Accurately entering data via Windows-based environment. - Intermediate computer skills. - Knowledge use of basic math and English spelling and grammar skills. - Ability to read and comprehend simple instructions, short correspondence, and memos. - Ability to write simple correspondence. - Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization. - Customer Service, Integrity/Honesty, Oral Communications, Motivation, Organizational/Planning/Organizing. - Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. - Ability to compute rates, ratio, and percent and to draw and interpret bar graphs. - Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. - Ability to deal with problems involving a few concrete variables in standardized situations. - Collaborative team spirit. - Accountable and able to work remotely and independently. - Able to pass background screening and drug tests pre and post hire – includes THC. - Verification of high school, GED, or college diploma upon request. - Timely responses from three professional references. - Able to provide a dedicated remote work location free from background noises, interruptions, and desk clutter. - Able to provide an ongoing reliable internet connection and access to a smart phone for Multi Factor Authentication and communication purposes. Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

Customer Service Representative 1

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Customer Support29 days ago
Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This job provides customer service in a call center environment by primarily receiving and responding to telephone inquiries from policyholders, beneficiaries, providers, agents, or others for information concerning insurance policies by performing the following duties: - Provides information and assistance to providers, agents, policyholders, and others by responding to telephone inquiries from CHCS third-party administrator clients to include Medicare Supplement and Life Policies. - Accurately provide information regarding various insurance questions (i.e., verification of benefits, claims status) by accessing and updating software system data within company response standards. - Provides service and follow-up on insurance questions by researching company records to obtain information requested by customer, performing routine transactions, and retrieving results from an online terminal. - Maintains working knowledge base of all company products and services. - Complying with company regulations regarding Privacy, confidentiality, and private health information. - Providing written and oral communication to policyholders, agents, providers, and others regarding inquiry status and resolution. - Initiate and complete Call Tracks, checklists, and supportive clerical responsibilities as necessary. - Ability and Flexibility to work various shifts as required. - Able to type speed of 30 wpm with 95% accuracy rate. Qualifications - High school diploma or general education degree (GED); and six months related call center experience and/or training. - Preferred Experience: Associate’s degree. - Experience with Long Term Care Insurance preferable in a Call Center setting. - 2 years related call center and customer service experience. Requirements - Collaborative team spirit. - Accountable and able to work remotely and independently. - Able to pass background screening and drug tests pre and post hire – includes THC. - Verification of high school, GED, or college diploma upon request. - Timely responses from three professional references. - Able to provide a dedicated remote work location free from background noises, interruptions, and desk clutter. - Able to provide an ongoing reliable internet connection and access to a smart phone for Multi Factor Authentication and communication purposes. Company Description Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

United States
Job Closed
Wellcove/CHCS-Services logo

Customer Support Representative

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Customer Support29 days ago
Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description The purpose of the Customer Support Representative for Electronic Visit Verification (EVV) and Facility Verification Department is to provide seamless support to clients by managing the usage and compliance of the EVV and Facility systems/platforms. The Customer Support Representative offers retraining, troubleshooting, and ongoing guidance to enhance system efficiency, improve client satisfaction, and ensure the accurate and compliant delivery of Home Care and Facility invoices to LTC insurance carriers. - Serve as a point of contact for clients utilizing Wellcove’s EVV and Facility platforms, addressing inquiries and resolving issues promptly. - Assist claimants, caregivers, home care agencies, and facilities in ongoing inquiries regarding the EVV and Facility platforms. - Provide training and guidance to clients on the use of EVV and Facility platforms, tools, and processes. - Gather required information from clients and accurately record data in Wellcove’s platforms/systems. - Maintain organized documentation for all client interactions, training sessions, and compliance activities. - Provide outstanding customer service via phone and email, displaying professionalism, empathy, a sense of urgency, and a genuine willingness to help. - Independently process caller requests accurately and promptly in Wellcove’s proprietary system and escalate as appropriate. - Comply with customer support objectives and performance standards. - Effectively use process resources to gain knowledge base and ensure the delivery of accurate information and error-free processing of requests. - Other duties as assigned. Qualifications - Excellent computer skills including proficiency with Microsoft Office applications. - Accountable and able to work remotely and independently. - Displays a positive ‘can do’/customer-first attitude. - Excellent communication skills and appropriate etiquette, great phone manners, and ability to speak with a wide range of personalities. - Demonstrate a high level of proficiency in the use of the English language in oral and written forms. - Willingness to learn new duties and technology-related skills as required. - Ability to effectively multi-task. - Collaborative team spirit. - Ability to pass background screening and drug test (includes marijuana). - Ability to provide responses from three professional references. Company Description Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

United States
Wellcove/CHCS-Services logo

Contact Center - Supervisor

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This job is responsible for providing quality and efficient customer service in a call center environment through the daily management of a team. This includes: - Hiring - Motivating - Recognizing - Rewarding - Coaching - Counseling - Training - Problem solving Additional responsibilities include assisting the manager with development, analysis, and implementation of staffing training. Supervisory Responsibilities - Directly supervises and manages the Associates within the Call Center Department. - Carries out supervisory responsibilities in accordance with organizational policies/procedures and applicable laws. - Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems/issues. Duties/Responsibilities - Provides daily directions and communication to employees for timely, efficient, and knowledgeable customer service calls. - Continually evaluates processes and procedures. - Responsible for suggesting methods to improve area operations, efficiency, and service to both internal and external customers. - Provides statistical and performance feedback and coaching on a regular basis to each team member. - Writes and administers performance reviews for skill improvement. - Provides support for employees through coaching, counseling, direction, and resolution. - Ensures employees have appropriate training and resources to perform their job. - Responds to and resolves employee relations issues expressed by team members. - Creates and maintains a high-quality work environment to motivate team members. - Addresse disciplinary and/or performance problems according to company policy. - Assists manager with daily operation of call center, including staffing and training development, analysis, and implementation. - Works as a member/leader of special or ongoing projects important to area/process improvement. - Shares continual responsibility for managing employees to ensure efficient and effective call handling. - Establishes work procedures and processes that support company and departmental standards. - Communicates with upper management regarding department or employee concerns. - Complies with company regulations regarding HIPAA, confidentiality, and private health information. Required Skills/Abilities - Excellent oral, written, and interpersonal communication skills. - Knowledge of Microsoft Office applications and telephone protocol. - Exceptional listening and analytical skills. - Strong knowledge of customer care processes and techniques. - Demonstrated ability to work well in a team environment. - Dedication to providing exceptional customer service. - Proven leadership experience. - Ability to develop and motivate a team. - Ability to provide and support company goals. - Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. - Ability to write reports, business correspondence, and procedure manuals. - Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. - Ability to calculate figures and amounts such as discounts, interest, and percentages. - Ability to apply concepts of basic algebra. - Ability to define problems, collect data, establish facts, and draw valid conclusions. - Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables. Education and Experience - One year certificate from college or technical school; or one year to 18 months related experience and/or training; or equivalent combination of education and experience; BA preferred. - 3-5 years customer service experience required; preferably within a healthcare setting. - Excellent communication skills, both verbal and written, are required. Physical Requirements - Regularly required to sit. - Frequently required to use hands to finger, handle, or feel. - Occasionally required to reach with hands and arms and talk or hear. - Must regularly lift and/or move up to 10 pounds. - Specific vision abilities required include close vision and ability to adjust focus. Job Type Full-time Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

Quality Assurance - Specialist 2, PCU

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

QA Engineer51 days ago
Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This job performs quality review for the LTC Insurance operational and claim environment by primarily reviewing processed transactions for accuracy. This includes, but is not limited, to the following essential duties and responsibilities: - Review all policy administration and claim level transactions against the standard operating procedures. - Maintain the review of all Daily and Monthly billing suspense items. - Responsible for reviewing benefit eligibility determinations to ensure that the claim recommendations meet the contractual obligations of the policy. - Assign and document all mechanical and financial errors as discovered. - Maintains a strong working knowledge base of all Long-Term care products and services. - Maintain production and quality standards established in the department. - Participate and support policy review decisions in the appeal process. - Monthly reporting to all engagement managers and supervisory staff on the quality results of their department and staff. - Participate in client level meetings. Create action plans as agreed upon with the client and meet all timelines and deliverables. - Complying with company regulations regarding HIPAA, confidentiality, and private health information. - Other duties may be assigned. - Ability and Flexibility to work overtime as required. Qualifications - In-depth insurance knowledge. Focus on Long Term Care Insurance and Benefit Eligibility determinations a plus. - Promote an exceptional level of excellence and pride in Customer Service. - Integrity/Honesty. - Sound interpersonal and communication skills. - Motivation. - Ability to multi-task. - Meticulous attention to detail. - Ability to lead others through performance and professionalism. - Ability to work in a fast-paced environment. - Highly developed problem-solving skills. - Organizational/Planning/Organizing. - Proficiency in basic computer applications is required. (MS Word, MS Excel). Company Description Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

Claims - Eligibility Specialist 2, Claims

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description This position is responsible for the review of policy benefit eligibility in accordance with policy, company, state, and federal guidelines. This position is for Long Term Care Insurance Plans administered by Prudential. Supervisory Responsibilities - None Duties/Responsibilities - Responsible for accurate/timely daily review of Long-Term Care benefit eligibility in accordance with policy provisions to determine appropriate eligibility approval or denial. - Responsible for accurate/timely determination of benefits and additional benefits applicable under policy provisions such as Wavier of Premium, Inflation Protection Options, Guaranteed Purchase Options, and other applicable rider/policy benefits. - Responsible for interpreting policy provisions to accurately determine claim benefits in accordance with policy benefits. - Responsible for timely request of claimant’s assessment and follow-up request of any/all required additional information, i.e., medical records, appropriate forms, statements, and certificates needed for proper eligibility determination. - Ensure systems and documents are updated on all follow-ups and status throughout the eligibility process. - Review and work other applicable reports and documents pertaining to eligibility determination. - Responsible for sending correspondence timely to claimant about benefit eligibility determination. - Respond appropriately and professionally to all oral and written external and/or internal correspondences received from stakeholders regarding benefits, eligibility, claim payments, denials and/or explanation of benefits. - Ensure appropriate systems are updated timely and clearly regarding eligibility rationale on how determinations were made in accordance with policy provisions and documents received. - Work with management, medical director, and client on review of complex eligibility cases. - Maintain current knowledge of federal, state, and insurance regulations and requirements. - Maintain working knowledge of all company and services pertaining to business segment. - Maintain working knowledge and proficiency in company claims and administrative software systems as well as Microsoft applications. - Maintain client and company quality and production standards. - Maintain knowledge of applicable company policies and procedures. - Operate within company regulations regarding HIPAA, fraud, confidentiality, and private health information. - Interact professionally with other business units to gather and analyze data needed to properly adjudicate claims and documentation of claims files. Qualifications - Excellent oral, written and interpersonal communication skills. - Knowledge of Microsoft Office applications and telephone protocol. - Exceptional listening and analytical skills. - Strong knowledge of customer care processes and techniques. - Demonstrated ability to work well in a team environment. - Dedication to providing exceptional customer service. - Proven leadership experience. - Ability to provide and support company goals. Education and Experience - Two years certificate/degree from college or technical school; or 4-7 years related experience and/or training; or equivalent combination of education and experience. Physical Requirements - N/A Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Job Closed
Wellcove/CHCS-Services logo

Account Coordinator, EVV

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Account Manager58 days ago
Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description The purpose of the Customer Support Representative for Electronic Visit Verification (EVV) and Facility Verification Department is to provide seamless support to clients by managing the usage, and compliance of the EVV and Facility systems/platforms. The Customer Support Representative offers retraining, troubleshooting, and ongoing guidance to enhance system efficiency, improve client satisfaction, and ensure the accurate and compliant delivery of Home Care and Facility invoices to LTC insurance carriers. - Serve as a point of contact for clients utilizing Wellcove’s EVV and Facility platforms, addressing inquiries and resolving issues promptly. - Assist claimants, caregivers, home care agencies, and facilities in ongoing inquiries regarding the EVV and Facility platforms. - Provide training and guidance to clients on the use of EVV and Facility platforms, tools, and processes. - Gather required information from clients and accurately record data in Wellcove’s platforms/systems. - Maintain organized documentation for all client interactions, training sessions, and compliance activities. - Provide outstanding customer service via phone and email, displaying professionalism, empathy, a sense of urgency, and a genuine willingness to help. - Independently process caller requests accurately and promptly in Wellcove’s proprietary system and escalate as appropriate. - Comply with customer support objectives and performance standards. - Effective use of process resources to gain knowledge base and ensure the delivery of accurate information and error-free processing of requests. - Other duties as assigned. Qualifications - Excellent computer skills including proficiency with Microsoft office applications. - Accountable and able to work remotely and independently. - Displays a positive ‘can do’/customer-first attitude. - Excellent communication skills and appropriate etiquette, great phone manners, and ability to speak with a wide range of personalities. - Demonstrate a high level of proficiency in the use of the English language in oral and written forms. - Willingness to learn new duties and technology-related skills as required. - Ability to effectively multi-task. - Collaborative team spirit. - Ability to pass background screening and drug test (includes marijuana). - Ability to provide responses from three professional references. - Able to provide a dedicated remote work location free from background noises, interruptions and desk clutter. - Able to provide reliable internet connection and access to a smart phone. Company Description At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

United States
Wellcove/CHCS-Services logo

EVV-Reporting Specialist

Wellcove/CHCS-Services

Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology. At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.

Full TimeRemoteMid LevelTeam 1,001-5,000

Role Description We are seeking a skilled Reporting Specialist to analyze business data, create accurate and insightful reports, and support decision-making across departments. The ideal candidate will have strong analytical abilities, experience with data tools, and the ability to present complex information clearly and concisely. Essential Job Functions - Collect, interpret, and validate data from multiple sources, ensuring accuracy and consistency - Create, maintain, and manage advanced reporting, dashboards, and BI solutions - Perform and document data analysis, validation, and mapping/design to improve reporting quality - Review and enhance existing systems, and collaborate with teams to integrate new reporting tools - Conduct market or operational research to identify trends and support strategic decisions - Develop and implement data collection systems to optimize statistical efficiency and data quality - Prepare executive-level reports summarizing trends, patterns, and forecasts using relevant data - Work with management and stakeholders to gather requirements, provide updates, and build relationships - Maintain compliance with data handling policies and ensure confidentiality of sensitive information - Identify process improvements to streamline reporting workflows and reduce errors - Analyze EVV data to identify missed visits, documentation inconsistencies, and compliance risks - Monitor visit verification trends and recommend corrective actions - Partner with operations to strengthen oversight and ensure adherence to state and federal EVV requirements - Perform monthly reporting - Other projects as defined Qualifications - Familiarity with automation tools to improve reporting efficiency - Excellent computer skills including, proficient with Microsoft Office Suite, NitroPro, and PowerBi - Ability to work remotely and independently - Excellent communication skills - Willing to learn new duties and technology-related skills, as required - Collaborative team spirit Education and Experience - Bachelor’s Degree preferred, or equivalent combination of education, training, and experience. Physical Requirements - Sedentary work. Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers. - The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading. - Work is performed in an office environment and requires the ability to operate standard office equipment and keyboards. Company Description Wellcove has been recognized as the nation’s leading full-service senior market solutions provider for over 25 years. Our solutions span the insurance senior market sector, focusing on long-term care and Medicare Supplement plans. However, we don’t stop there. Wellcove also addresses challenges faced in accident & health, disability, and supplemental health insurance programs. Our team provides individuals and their families with peace of mind knowing their insurance needs will be met in a thoughtful, efficient manner. We are able to do this because of our dedicated associates, innovative solutions, and state-of-the-art technology.

United States

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