Demo

Claims Resolution Analyst - Hybrid

Acosta Group
Eden, NC Full Time
POSTED ON 3/5/2025
AVAILABLE BEFORE 5/4/2025

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.

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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 andcustomer 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 withthem 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

  • Bachelor's Degree

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 informsothers 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 judgementsand 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

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ABOUT US

Acosta and Mosaic are the sales and marketing powerhouses behind the most recognized and proven brands with top retailers in the United States and Canada. We offer flexible services that maximize efficiency. Acosta has the talent and technology to build data-, reach- and relationship-driven strategies to execute those strategies, and the tools to monitor, track and optimize metrics-based results for customers and retailers.

Acosta and its subsidiaries, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. Acosta may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.

Acosta et Mosaic sont les moteurs des ventes et du marketing derrière les marques les plus reconnues et éprouvées avec les meilleurs détaillants aux États-Unis et au Canada. Nous offrons des services flexibles qui maximisent l'efficacité. Acosta possède le talent et la technologie pour élaborer des stratégies axées sur les données, la portée et les relations pour exécuter ces stratégies, ainsi que les outils pour surveiller, suivre et optimiser les résultats basés sur des mesures pour les clients et les détaillants.

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: 2961

Salary : $31,800 - $39,700

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