Claims Analysis Expert

2 weeks ago

Tampa, Florida, United States Acosta Sales & Marketing Full time
Position Overview

The Claims Resolution Analyst will play a pivotal role in managing and resolving claims that require further validation or are incomplete. This individual will be tasked with evaluating claims and determining their legitimacy.


Key Responsibilities

1. Manage escalated claims by identifying the reasons for escalation and providing timely resolutions as prioritized by the Supervisor.

2. Locate and associate invoices, contracts, and Proof of Performance with claims as necessary.

3. Utilize various systems, reports, and Standard Operating Procedures to navigate assigned claim processes and collect supporting information.

4. Address invalid claims in accordance with established policies and guidelines.

5. Correct and resolve claims that have been erroneously marked as 'clean passed.'

6. Investigate validation issues and propose suitable solutions.

7. Regularly review the claims dashboard for actionable items.

8. Strive to meet or exceed client and customer expectations.

9. Make final determinations regarding the validity of escalated claims.

10. Prepare and send compliant promotion packages for clearance.

11. Communicate with Sales, clients, customers, and management to gather necessary information.

12. Proactively manage timelines to ensure timely processing of claims.

13. Maintain regular communication with clients and customers, offering value-added solutions.

14. Appropriately escalate issues to the supervisor for complex client and customer situations.

15. Understand the nature of escalations and employ analytical skills to prevent recurrence.

16. Work towards reducing defects and achieving automation targets by keeping Standard Operating Procedures updated.

17. Monitor escalation data to identify root causes and address them effectively.

18. Collaborate with Sales, clients, customers, and management to discuss defect issues and develop solutions.

19. Identify operational challenges that hinder claim resolution and propose effective solutions.

20. Fulfill other duties as assigned.


Qualifications

Education: Bachelor's Degree.

Experience: A minimum of four years in claims management is preferred. Experience in food brokerage or sales administration is highly desirable. Relationship management experience is also preferred.

Skills and Abilities:

- Demonstrates accountability for job performance and proactively communicates challenges.

- Adapts positively to change and maintains constructive work behaviors during transitions.

- Meets attendance expectations and informs others in advance of any commitments that cannot be fulfilled.

- Aligns actions with organizational goals and prioritizes organizational needs in decision-making.

- Utilizes a logical approach to decision-making, carefully reviewing facts before reaching conclusions.

- Gathers relevant information and consults with appropriate stakeholders to address situations effectively.

- Exhibits clear, unbiased, and analytical thinking supported by evidence.

- Communicates effectively with others and is proficient in using standard office equipment.


About Acosta

Acosta and Mosaic are recognized leaders in sales and marketing, partnering with top brands and retailers across the United States and Canada. We provide flexible services designed to enhance efficiency and effectiveness.

Our team leverages talent and technology to develop data-driven strategies that are executed with precision, monitoring and optimizing results for our clients.

Acosta is committed to equal opportunity employment and providing accommodations for individuals with disabilities as required by law.

The above statements are intended to outline the general nature and level of work performed by individuals in this role and are not exhaustive of all responsibilities and skills required.

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