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Lead LTC Claims Escalation Representative- Resolution Specialist

Company: Genworth
Location: Lynchburg
Posted on: October 3, 2021

Job Description:


Lead LTC Claims Escalation Representative- Resolution Specialist


Lynchburg, VA, Richmond, VA or Remote

This position is available to Virginia residents as Richmond, Virginia in-office applicants or remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin.

The Resolution Specialist responds to customer concerns where a miss in our process is perceived. You will work in a fast-paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements.

• Under minimal supervision, responds to inquiries from various internal and external customers via telephone, correspondence and personal contact.
• May address topics such as policy provisions; Department of Insurance inquiries; company procedures; claims processes and specific federal and state requirements, regulations and deadlines in order to meet specific service level agreements.
• Responsible for receiving information about customer problems from a variety of sources; documenting information, progress and status regarding the receipt, research, resolution and communication of customer problems.
• Builds positive relationships with team members, while working in a fast paced highly flexible environment.
• Remains current on changes to product offerings, processes and operational procedures to ensure compliance.
• Aggressively seeks out and learns new processes, procedures and system transactions through formal and informal training opportunities.
• Tracks trends, reports out on metrics and initiates changes to existing processes based on complaints.
• May provide some coaching to associates regarding processes and handling of difficult situations and/or callers; providing supervisors with information/feedback that will assist in overall departmental goal attainment.
• May provide some on the job training to team members in areas of personal expertise.
• May develop procedural and/or training documentation to support new regulations or product introductions.

• 2 years of experience in adjudicating Long Term Care claims.
• You have solid to exceptional performance in current role, as measured by productivity metrics, problem resolution, quality and feedback from supporting areas and also have deep experience in adjudicating Long Term Care claims.
• Proven experience coaching others in customer service and phone skills.
• Exceptional written and verbal communication skills.
• Prior experience in a call center environment.
• Demonstrated experience providing excellent customer service.
• Ability to maintain confidentiality of customer and employee information.
• Excellent oral and written communication skills along with the ability to both coach associates as well as present to leadership.
• Demonstrated PC / Technical skills - Windows based mainframe experience, as well as MS Office Suite (i.e. Excel, Word, and PowerPoint).
• Ability to work independently and as a team.
• Ability to solve problems and resolve conflicts.

• College Degree (BS/BA) and/or equivalent work experience.
• Proven ability to work with in both PEGA Customer Service and PEGA Claims.
• Proven ability to network and develop relationships across teams as well as drive change to promote excellent service to our customers.
• Excellent critical thinking, organizational and prioritization skills with the ability to handle multiple tasks and meet deadlines while working independently.
• Experience developing training materials, documenting processes, and interpreting contract language and/or procedures.
• Medical experience, work with the elderly or understanding or long term care industry helpful.


  • We have a real impact on the lives of the people we serve

  • We work on challenging and rewarding projects

  • We give back to the communities where we live

  • We offer competitive benefits including:

    • Medical, Dental, Vision, Flexible Spending Account benefit options available beginning your first day  

    • Generous Choice Time Off your first full year

    • 12 Paid Holidays

    • 40 hours of volunteer time off

    • 401K Account with matching contributions

    • Tuition Reimbursement and Student Loan Repayment

    • Paid Family Leave

    • Child Care Subsidy Program


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. 

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

We know we can’t deliver on our mission unless we deliver for our employees. That’s why we’re committed to creating a work environment that fosters inclusion, camaraderie, rewarding work, community involvement, and a focus on our employees’ well-being. We know each employee contributes in their own unique way and we’re dedicated to supporting every one of them to help them reach their full potential.

Keywords: Genworth, Lynchburg , Lead LTC Claims Escalation Representative- Resolution Specialist, Other , Lynchburg, Virginia

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