REMOTE Claims Resolution Analyst

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Posted 15 days ago United States Salary undisclosed
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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.

Processes 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 manages 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 add 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

Other duties as assigned

Four years claims experience preferred

Food brokerage experience and/or clients' experience in sales administration is strongly preferred

Relationship management experience preferred

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 exhibiting constructive work behaviors during periods of transition

Meets work and attendance expectation; informs others in advance when commitments cannot be fulfilled

Actively supports organizational goals and values; aligns actions around organizational goals; gives priority to organizational needs and concerns when making decisions

Takes a reasoned logical approach in making judgments 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

Acosta Sales & Marketing is an Equal Opportunity Employer

Colorado Specific Pay Range: $15.00 - $16.00

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