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Claims Resolution Analyst

1 month ago

Tampa, United States Acosta Group Full time

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, assess the reason for the escalation, and provide resolution in priority order as directed by the Supervisor. Search for and link invoices, contracts, and Proof of Performance to claims as needed. Use systems, reports, and Standard Operating Procedures to work assigned claim steps and gather supporting claims information. Process invalid claims in accordance with set policies and guidelines. Correct and resolve claims "clean passed" in error. Research validation issues and recommend appropriate solutions. Review claims dashboard for actionable items on a frequent basis. Meet or exceed client and customer goals and requirements. Make the final decision on claims validity for escalated claims. Send compliant promotion package for clearing. Contact Sales, clients, customers, and management team for information as needed. Proactively manage client and customer target dates to ensure claims are processed in a timely manner. Communicate with clients and customers on a regular basis and provide value-added solutions. Escalate appropriately to the supervisor when needed to get information or handle complex client and customer situations. Understand types of escalations and use problem-solving and analytical skills to resolve them so they do not repeat. Work to decrease defects and achieve automation (aka Ready to Clear) targets by keeping Standard Operating Procedures updated. Monitor specific escalations data to determine the root cause of an escalation, where it originated, and why it occurred. Discuss defect issues with Sales, clients, customers, and management team and work with them to address the root cause. Recognize and provide solutions for operational obstacles that delay work completion on claims issues. Meet 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. Knowledge, Skills, and Abilities Accept accountability for job performance; proactively inform others when problems may limit the ability to meet expectations. Accept change as a normal part of doing business, maintain a positive attitude, and exhibit constructive work behaviors during periods of transition. Meet work and attendance expectations; inform others in advance when commitments cannot be fulfilled. Actively support organizational goals and values; align actions around organizational goals; give priority to organized needs and concerns when making decisions. Take a reasoned logical approach in making judgments and decisions, carefully review available facts and information before reaching any conclusions. Identify and gather relevant information, consult the right people, and ask the right questions in a given situation. Demonstrate 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 REQUIREMENTS ABOUT US Acosta, and its subsidiaries, is an Equal Opportunity Employer. #J-18808-Ljbffr