Claims Specialist

Job Description

Sharp Imaging and Information Company of America (SIICA) is seeking a Claims Specialist to manage Point of Sale (POS) data and process back-end pricing rebates/credits. The Claims Specialist will resolve issues and disputes accurately and timely.

Responsibilities:

• Ingest and cleanse partner Point of Sale (POS) data in Vistex Go-to-Market Suite (GTMS).
• Upload manual POS files timely and track monthly progress.
• Review data for deficiencies or errors, correct any inaccuracies in POS daily.
• Investigate, research, and identify business entities with minimal information provided.
• Cleanse, enrich, and monitor master data elements (customer, product, and pricing).
• Collaborate with POS reporters to improve the completeness and accuracy of the data submitted in Electronic Data Interchange (EDI) or manual submissions.
• Identify issues related to master data that impact POS and/or claims data.
• Process and issue credits for incoming claims in an accurate and timely manner.
• Upload claim files timely and track weekly/monthly progress.
• Resolve and analyze claim errors/rejections; escalate to management and/or Bid Desk for further internal review as needed.
• Communicate discrepancies/denials to claim partner for review and alignment.
• Issue credits for approved claims and send claim discrepancy report to claim partner.
• Work with Accounts Receivable to reconcile discrepancies/denials for collection.
• Collaborate with claim partners to improve the claim submission data for processing efficiency.
• Address any internal and/or external issues or questions regarding data or claims in an accurate and timely manner.
• Validate and create credits honoring price protection in SAP.

Requirements:

• High school diploma or GED required.
• Associate degree in Business or work-related experience.
• Minimum one year rebate/claim processing, data management, or equivalent experience.
• Demonstrated problem-solving skills with a proficient understanding of processes.
• Proven detail-oriented individual who enjoys managing large amounts of data.
• Established strong process and organizational skills with the ability to process high volumes of transactions, research errors and exceptions, and manage to completion.
• Ability to interact with a variety of individuals/functions within the organization as well as with external customers.
• Ability to work independently in a fast-paced, professional team environment with minimal supervision.
• Demonstrated experience creating and managing reports that identify discrepancies.
• Proven capacity to identify and maintain consistent accuracy.
• Strong oral and written communication skills.
• Intermediate Microsoft application user including Outlook, Word, and especially Excel.
• Ability to multi-task and prioritize.
• Experience with Salesforce, Channel Data Management (CDM), SAP ECC6, Vistex is a plus.

Benefits:

• Comprehensive, family-friendly healthcare plans (medical, dental, vision).
• 401k retirement plan with a competitive match and plenty of financial support tools.
• Employee Assistance Plan to care for you and your family's mental and behavioral health, balance, and support.
• Financial protection for you and your family (life insurance and disability insurance)
• Rewarding and wholistic wellness program.
• Training, professional development, and mentorship
• Full suite of voluntary insurance benefits for financial planning (auto, home, ID protection and legal)
• Dynamic culture eager to innovate, enhance diversity, and work smarter.