Claims Processing Specialist

This role is Remote

Job Summary:
We are seeking a detail-oriented Claims Processing Specialist to handle and process escalated retail claims, validate claim accuracy, and ensure compliance with set policies and guidelines. This role requires strong analytical and problem-solving skills to assess claim validity, resolve discrepancies, and communicate effectively with internal and external stakeholders.

Key Responsibilities:

• Process escalated claims, determine the reason for escalation, and provide resolution based on priority.
• Research and link invoices, contracts, and Proof of Performance to claims as needed.
• Utilize systems, reports, and Standard Operating Procedures to process assigned claims and gather supporting documentation.
• Identify and correct claims that were mistakenly approved.
• Research validation issues and recommend appropriate solutions.
• Monitor claims dashboards for actionable items and ensure timely processing.
• Make final decisions on the validity of escalated claims.
• Prepare and send compliant promotion packages for clearing.
• Communicate regularly with Sales, clients, customers, and management to obtain necessary claim information.
• Proactively manage client and customer deadlines to ensure timely claim resolution.
• Use problem-solving and analytical skills to identify recurring escalation issues and implement corrective actions.
• Work towards reducing defects and increasing automation by keeping Standard Operating Procedures up to date.
• Monitor escalation data to determine root causes and collaborate with stakeholders to address systemic issues.
• Recognize operational obstacles delaying claim resolution and propose effective solutions.
• Perform additional duties as assigned.

Qualifications:

• Four years of claims processing experience preferred.
• Experience in food brokerage and/or sales administration is a plus.
• Strong analytical and problem-solving skills with attention to detail.
• Ability to work in a fast-paced environment and manage multiple priorities.
• Effective communication skills for interacting with internal and external partners.
• Proficiency in data management systems and claim processing software.

This is an excellent opportunity for a professional with claims experience who thrives in a problem-solving environment and enjoys improving processes for efficiency and accuracy.

EOC

Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity.
Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law

Ascendo is a certified minority owned staffing firm, and we welcome and celebrate diversity. Ascendo is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, parental status, military service or any other characteristic protected by federal, state or local law.

Contact information

Angela Rodriguez