Claims Resolution Analyst - Remote

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

• High School Diploma/GED
  
  
  

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
  
  
  

\#DiscoverYourPath

About Us

Acosta Group is a collective uniting the most trusted retail, marketing, and foodservice agencies—Acosta, ActionLink, CORE Foodservice, CROSSMARK, Mosaic, Premium Retail Services, and Product Connections. Together, we connect consumers with the brands they love through omnichannel selling, merchandising, brand advocacy, and integrated marketing.

We recognize our associates are the foundation of our success. That’s why we prioritize your growth, development, and well-being to help you reach your full potential. With programs designed to support a fulfilling work-life balance, we offer opportunities that fit your lifestyle and ambitions—whether you’re looking for part-time flexibility or full-time career advancement.

Ready for a career path that’s as unique as you? Discover your path at Acosta Group!

We empower you to Discover Your Path and fully embrace BEING YOU as you shape your journey with us. At Acosta Group, we value equal opportunity in employment practices and career progression. Employment decisions are based on business needs, job requirements, and individual qualifications without regard to race/ethnicity, gender/gender identity, disability, veteran status, or any other basis protected by federal, state, and local laws. Acosta Group will provide reasonable accommodations for applicants with physical or mental disabilities to complete applications or interviews for employment. If reasonable accommodation is needed to participate in the job application or interview process, please contact [email protected]

Acosta Group and its subsidiaries believe the posted compensation range accurately reflects this role at the time of posting. Final pay may vary based on qualifications and location, and the range may be updated in the future.

Acosta Group is an E-Verify employer. By applying, you agree to our Privacy Statement and Terms of Conditions.

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Acosta, and its subsidiaries, is an Equal Opportunity Employer

Job Category: Sales Support

Position Type: Full time

Business Unit: Sales

Salary Range: $31,800.00 - $39,700.00

Company: Acosta Employee Holdco LLC

Req ID: 5286