Claims Resolution Analyst

1 month ago

Tampa, United States Acosta Full time
Job Description

This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be responsible for analyzing claims and making decisions about their validity. The position will be a communicator to internal and external business partners and a problem solver/agent for change to provide continuous improvements.

Responsibilities

  • Process escalated claims, assesses the reason for the escalation, and provides resolution in priority order as directed by the Supervisor.
  • Searches for and links invoices, contracts, and Proof of Performance to claims as needed.
  • Uses systems, reports, and Standard Operating Procedures to work assigned claim steps and gather supporting claims information.
  • Processes invalid claims in accordance with set policies and guidelines.
  • Corrects and resolves claims "clean passed" in error.
  • Researches validation issues and recommends appropriate solutions.
  • Reviews claims dashboard for actionable items on a frequent basis.
  • Meets or exceeds client and customer goals and requirements
  • Makes the final decision on claims validity for escalated claims
  • Sends compliant promotion package for clearing
  • Contacts Sales, clients, customers, and management team for information as needed.
  • Proactively managers client and customer target dates to ensure claims are processed in a timely manner.
  • Communicates with clients and customers on a regular basis and provides value added solutions.
  • Escalates appropriately to the supervisor when needed to get information or handle complex client and customer situations.
  • Understands types of escalations and uses problem solving and analytical skills to resolve them so they do not repeat.
  • Works to decrease defects and achieve automation (aka Ready to Clear) targets by keeping Standard Operating Procedures updated.
  • Monitors specific escalations data to determine the root cause of an escalation, where it originated and why it occurred.
  • Discusses defect issues with Sales, clients, customers, and management team and works with them to address the root cause.
  • Recognizes and provides solutions for operational obstacles that delay work completion on claims issues.
  • Meeting the physical requirements - listed below
  • Other duties as assigned
Qualifications

Education
  • Bachelor's Degree
Work Experience
  • Four years of claims experience preferred
  • Food brokerage experience and/or client experience in sales administration is strongly preferred
  • Relationship management experience preferred
Knowledge, Skills and Abilities
  • Accepts accountability for job performance; proactively informs others when he/she encounters problems that may limit his/her ability to meet expectations.
  • Accepts change as a normal part of doing business, maintains a positive attitude and exhibits constructive work behaviors during periods of transition.
  • Meets work and attendance expectations; informs others in advance when commitments cannot be fulfilled.
  • Actively supports organizational goals and values; aligns actions around organizational goals; gives priority to organized needs and concerns when making decisions.
  • Takes a reasoned logical approach in making judgements and decisions, carefully reviews available facts and information before reaching any conclusions.
  • Identifies and gathers relevant information, consults the right people and asks the right questions in a given situation.
  • Demonstrates disciplined thinking that is clear, unbiased, analytical, and informed by evidence.
  • Effectively communicate with others. Must be able to operate a calculator, computer, printer, fax machine, telephone, copier, and shredder.
Physical
  • Seeing
  • Listening


About Us

Acosta and Mosaic are the sales and marketing powerhouses behind the most recognized and proven brands with top retailers in the United States and Canada. We offer flexible services that maximize efficiency. Acosta has the talent and technology to build data-, reach- and relationship-driven strategies to execute those strategies, and the tools to monitor, track and optimize metrics-based results for customers and retailers.

The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Acosta Group reserves the right to modify all or part of any job descriptions at its discretion in order to meet and or exceed the needs of the business.

The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.

The Acosta Group utilizes E-Verify for validating the ability to work in the United States for all job candidates. If you want more information on what this entails and your rights as a job applicant, please use the link provided to access information on our use of E-Verify and your right to work. Employer Resources (e-verify.gov)

The Acosta Group is an Equal Opportunity Employer.

We are committed to providing accommodations for persons with disabilities. If you require accommodation, please contact EmployeeServices@acosta.com, we will work with you to meet your needs, to the extent required by law.

By submitting your application, you agree with and accept the Acosta Privacy Statement and Terms of Conditions.

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