About the job
Welcome to our organization, where we strive for excellence in every aspect of our operations. Join us in creating a consistent and professional environment across all job postings.
Overview
The Claims Management Specialist plays a crucial role in overseeing Point of Sale (POS) data management and ensuring efficient processing of back-end pricing rebates and credits. This position is key to swiftly resolving any issues or disputes that may arise, ensuring accuracy and timeliness in all operations.
Responsibilities
- Effectively ingest and cleanse partner Point of Sale (POS) data using the Vistex Go-to-Market Suite (GTMS), ensuring accuracy and timely uploads.
- Upload manual POS files with precision and track monthly progress diligently.
- Review submitted data for deficiencies or errors and correct inaccuracies on a daily basis.
- Investigate and identify business entities with minimal information provided to ensure comprehensive data management.
- Maintain and enhance master data elements such as customer, product, and pricing information.
- Collaborate with POS reporters to enhance the completeness and accuracy of data submissions, whether through Electronic Data Interchange (EDI) or manual channels.
- Identify and troubleshoot issues related to master data that could impact POS and claims data.
- Process and issue credits for incoming claims accurately and promptly.
- Timely upload claim files and monitor weekly/monthly progress.
- Analyze claim errors and rejections; escalate to management or Bid Desk for further review as necessary.
- Communicate discrepancies or denials to claim partners for alignment and resolution.
- Issue credits for approved claims and prepare discrepancy reports for claim partners.
- Work closely with Accounts Receivable to reconcile discrepancies or denials effectively.
- Partner with claim stakeholders to enhance claim submission data and improve processing efficiency.
- Timely address any internal or external inquiries regarding data or claims, ensuring accurate and clear communication.

