Acosta
Claims Resolution Specialist - Hybrid
Acosta, Issaquah, Washington, United States, 98027
Job Description
The Claims Resolution Supervisor supervises Claims Resolution Analysts and Claims Resolution Specialists and is responsible for timely and financially compliant validation of incomplete and escalated claims. This person will analyze incomplete and escalated claims to increase Ready to Clear rate by determining the root cause and taking action to resolve it. The incumbent will ensure that Claims Resolution Analysts and Specialists are trained and proficient in their assigned work using analytical tools, quality reviews, client feedback, and management guidance. The Claims Resolution Supervisor also ensures that their associates are compliant with client, department, and company policy.
Responsibilities
•Supervises Claims Resolution Analysts and Specialists to include evaluating associates, assisting in hiring, addressing individual performance issues, workload balancing, and salary recommendations
•Consistently demonstrates a high level of proficiency in processing claims, Acosta, client and customer systems, and client, customer and company policies and procedures.
•Monitors attendance to ensure full coverage
•Maintains accurate attendance and payroll records
•Ensures that associate quality scores, ready to clear rate and productivity meet or exceed expectations
•Communicates daily with other supervisors and the hub manager to ensure associates are handled consistently across the hub
•Ensures adherence to company and department policy, client service level agreements and financial requirements for assigned team
•Serves as the Acosta resource for assigned clients and customers needing information and/or assistance with claims
•Uses the required work management process to prevent backlog
•Resolves validation and clearing issues by communicating with associates, sales, clients, customers and the management team, and provides recommendations to prevent them in the future
•Escalates recurring claims processing errors to the Hub Manager for assistance
•Escalates associate issues to the hub manager for assistance
•Serves as mentor/resource for internal and external associates to improve accuracy and timeliness of claims processes
•Works with management to improve claims and repayment processes
•Uses reporting tools and one-on-one sessions to monitor team performance/task completion on a daily, sometimes hourly basis and ensures all claims functions are current and are being performed accurately and efficiently
•Performs daily maintenance of the claims processing system to ensure that all claims are entered, accurate, assigned correctly, matching client records
•Maintains excellent working relationships with customers, clients, sales, management team
•Other duties as assigned
Qualifications
Work and Experience Requirements:•High School diploma or equivalent
•Bachelors' degree preferred
•2 years of supervisory experience
•Background in business process solutions and/or brokerage field preferred
Knowledge, Skills, and Abilities Required:•Accepts accountability for job performance; proactively informs others if problems limit the 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
•Actively supports organizational goals and values; aligns actions around organizational goals; gives priority to organizational needs and concerns when making decisions
•Makes sound decisions based on the limited information available at the time, achieving forward progress even under ambiguous circumstances
•Takes a reasoned logical approach in making judgments and decisions, carefully reviews available facts and information before reaching any conclusions
•Sets high standards for personal and group accomplishment; creates measures to monitor progress toward goals; aggressively works to meet or exceed expectations
•Demonstrates an authentic interpersonal style that engages others and encourages high performance; uses coaching and mentoring skills to develop and support employee growth
Physical Requirements:
•Seeing
•Listening
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.
The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Acosta Group reserves the right to modify all or part of any job descriptions at its discretion in order to meet and or exceed the needs of the business.
The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.
The Acosta Group utilizes E-Verify for validating the ability to work in the United States for all job candidates. If you want more information on what this entails and your rights as a job applicant, please use the link provided to access information on our use of E-Verify and your right to work. Employer Resources (e-verify.gov)
The Acosta Group is an Equal Opportunity Employer.
We are committed to providing accommodations for persons with disabilities. If you require accommodation, please contact EmployeeServices@acosta.com, we will work with you to meet your needs, to the extent required by law.
By submitting your application, you agree with and accept the Acosta Privacy Statement and Terms of Conditions.
The Claims Resolution Supervisor supervises Claims Resolution Analysts and Claims Resolution Specialists and is responsible for timely and financially compliant validation of incomplete and escalated claims. This person will analyze incomplete and escalated claims to increase Ready to Clear rate by determining the root cause and taking action to resolve it. The incumbent will ensure that Claims Resolution Analysts and Specialists are trained and proficient in their assigned work using analytical tools, quality reviews, client feedback, and management guidance. The Claims Resolution Supervisor also ensures that their associates are compliant with client, department, and company policy.
Responsibilities
•Supervises Claims Resolution Analysts and Specialists to include evaluating associates, assisting in hiring, addressing individual performance issues, workload balancing, and salary recommendations
•Consistently demonstrates a high level of proficiency in processing claims, Acosta, client and customer systems, and client, customer and company policies and procedures.
•Monitors attendance to ensure full coverage
•Maintains accurate attendance and payroll records
•Ensures that associate quality scores, ready to clear rate and productivity meet or exceed expectations
•Communicates daily with other supervisors and the hub manager to ensure associates are handled consistently across the hub
•Ensures adherence to company and department policy, client service level agreements and financial requirements for assigned team
•Serves as the Acosta resource for assigned clients and customers needing information and/or assistance with claims
•Uses the required work management process to prevent backlog
•Resolves validation and clearing issues by communicating with associates, sales, clients, customers and the management team, and provides recommendations to prevent them in the future
•Escalates recurring claims processing errors to the Hub Manager for assistance
•Escalates associate issues to the hub manager for assistance
•Serves as mentor/resource for internal and external associates to improve accuracy and timeliness of claims processes
•Works with management to improve claims and repayment processes
•Uses reporting tools and one-on-one sessions to monitor team performance/task completion on a daily, sometimes hourly basis and ensures all claims functions are current and are being performed accurately and efficiently
•Performs daily maintenance of the claims processing system to ensure that all claims are entered, accurate, assigned correctly, matching client records
•Maintains excellent working relationships with customers, clients, sales, management team
•Other duties as assigned
Qualifications
Work and Experience Requirements:•High School diploma or equivalent
•Bachelors' degree preferred
•2 years of supervisory experience
•Background in business process solutions and/or brokerage field preferred
Knowledge, Skills, and Abilities Required:•Accepts accountability for job performance; proactively informs others if problems limit the 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
•Actively supports organizational goals and values; aligns actions around organizational goals; gives priority to organizational needs and concerns when making decisions
•Makes sound decisions based on the limited information available at the time, achieving forward progress even under ambiguous circumstances
•Takes a reasoned logical approach in making judgments and decisions, carefully reviews available facts and information before reaching any conclusions
•Sets high standards for personal and group accomplishment; creates measures to monitor progress toward goals; aggressively works to meet or exceed expectations
•Demonstrates an authentic interpersonal style that engages others and encourages high performance; uses coaching and mentoring skills to develop and support employee growth
Physical Requirements:
•Seeing
•Listening
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.
The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Acosta Group reserves the right to modify all or part of any job descriptions at its discretion in order to meet and or exceed the needs of the business.
The Acosta Group, in good faith, believes that this posted range of compensation is the accurate range for this role at the time of this posting. The Acosta Group may ultimately pay more or less than the posted range depending on candidate qualifications and locations. This range may be modified in the future.
The Acosta Group utilizes E-Verify for validating the ability to work in the United States for all job candidates. If you want more information on what this entails and your rights as a job applicant, please use the link provided to access information on our use of E-Verify and your right to work. Employer Resources (e-verify.gov)
The Acosta Group is an Equal Opportunity Employer.
We are committed to providing accommodations for persons with disabilities. If you require accommodation, please contact EmployeeServices@acosta.com, we will work with you to meet your needs, to the extent required by law.
By submitting your application, you agree with and accept the Acosta Privacy Statement and Terms of Conditions.