Claims Validation Specialist

2 weeks ago

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

The Claims Resolution Analyst will play a crucial role in managing and resolving claims that require further validation or are incomplete. This individual will analyze claims to determine their legitimacy and ensure effective communication with both internal and external stakeholders.


Key Responsibilities
  • Handle escalated claims, identifying the reasons for escalation and prioritizing resolutions as instructed by the Supervisor.
  • Link invoices, contracts, and Proof of Performance to claims as necessary.
  • Utilize systems, reports, and Standard Operating Procedures to execute assigned claim processes and collect necessary supporting information.
  • Process claims deemed invalid in accordance with established policies and guidelines.
  • Correct claims that have been erroneously marked as 'clean passed.'
  • Investigate validation issues and propose suitable solutions.
  • Regularly review the claims dashboard for actionable items.
  • Meet or exceed client and customer expectations and requirements.
  • Make final determinations regarding the validity of escalated claims.
  • Prepare and send compliant promotion packages for clearance.
  • Engage with Sales, clients, customers, and management for information as required.
  • Proactively manage timelines to ensure timely processing of claims.
  • Maintain regular communication with clients and customers, providing valuable solutions.
  • Escalate issues to the supervisor when necessary to obtain information or resolve complex situations.
  • Understand various types of escalations and apply problem-solving and analytical skills to prevent recurrence.
  • Work towards reducing defects and achieving automation targets by keeping Standard Operating Procedures current.
  • Monitor specific escalation data to identify root causes and their origins.
  • Collaborate with Sales, clients, customers, and management to address defect issues.
  • Identify operational obstacles that hinder timely completion of claims-related tasks.
  • Fulfill additional duties as assigned.

Qualifications

Education: Bachelor's Degree.

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

Knowledge, Skills, and Abilities:

  • Demonstrates accountability for job performance and proactively communicates any challenges that may impact expectations.
  • Embraces change as a natural aspect of business, maintaining a positive attitude during transitions.
  • Meets work and attendance standards, notifying others in advance of any commitments that cannot be fulfilled.
  • Supports organizational goals and values, prioritizing needs and concerns in decision-making.
  • Employs a logical approach to judgments and decisions, thoroughly reviewing available information before reaching conclusions.
  • Effectively gathers relevant information and consults appropriate individuals when necessary.
  • Exhibits disciplined, clear, and unbiased analytical thinking.
  • Communicates effectively with others and operates standard office equipment.

Physical Requirements:
  • Visual acuity.
  • Auditory perception.

About Acosta

Acosta and Mosaic serve as the leading sales and marketing forces behind some of the most recognized brands with top retailers across the United States and Canada. We provide flexible services designed to maximize efficiency.

Acosta possesses the talent and technology to develop data-driven strategies and the tools necessary to monitor, track, and optimize results for our customers and retailers.

Acosta is an Equal Opportunity Employer committed to providing accommodations for individuals with disabilities. We will work with you to meet your needs as required by law.

The information provided above is intended to outline the general nature and level of work performed by individuals in this role. It is not an exhaustive list of all responsibilities, duties, and skills required.

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