ESP Prior Approval Escalation Specialist

ESP Prior Approval Escalation Specialist

Melbourne, Florida

At Percepta, we bring first-class service across each market we support. As an ESP Prior Approval Escalation Specialist in Melbourne, Florida, you’ll be a part of creating and delivering amazing customer experiences, while also enjoying the satisfaction of being part of a unique culture.

Prior Approval Escalation Specialist is responsible for reviewing, researching and providing responses to management on field and legal escalations related to Prior Approval and claims processes. The Escalation Specialist will also evaluate existing processes and perform root cause analysis when customer expectations were not met to provide management recommendations for improvement. Additionally, the Specialist will support the Centro claim reconciliation & payment process, back office reporting and process certain goodwill requests.

The Escalation Specialist will interact directly with the clients on multiple duties in a professional manner.

• Assist with researching and summarizing field & legal escalations for the business partner, review claims, summarize findings and recommend action plans
• Identify process breakdowns and gaps in the claims handling process, perform root cause analysis and recommend process or policy enhancements to improve customer experiences
• Reconcile Centro Inspection Agency invoice vs. Prior Approval claim data
• With management approval, approve invoice payments for Centro Inspection Agency in CPARS
• Assist with standard monthly claim data reporting
• Process low cost Goodwill claims for lease plan rental claims and assist with OWS goodwill approvals
• Review and compile Dealer and Customer survey verbatim’ s on a daily, weekly, and monthly basis, summarize findings, recommend actions to address feedback and disseminate reporting to team leadership
• Compiles and distributes dealer/customer feedback for personnel recognition via recognition board and individual contribution recognition letters
• Assist with special program specific projects, such as;
  Blue Bird Bus by validating and reconciling claims versus OWS submission
  
  Validate OWS claim coverage categories, including parts coverage and coverage levels, Verifies additions or deletions to parts coverage on an annual basis
• Reviews parts coverage Escalations from agents and dealers through FMC Dealer and verify coverage status
• Maintain and update global parts coverage tables in multiple Ford systems by working directly with the appropriate client on a daily basis to ensure component coverage is accurate
• Lead team meetings if a team leader is unavailable
• Coordinate with progression team leader on selection of agents, training plan, testing, presentation preparation, and knowledge base support for agents moving from TSR I to TSR II
• Provide access to specific systems with client approval
• Provide status updates on Safe Guard reviews
• ESP Claim reviews
• Compile and edit U.S., FOC, FOM, and OWS claims process and parts coverage manuals for dealers
• Provides input on tools, job aides and bulletins to improve claim processing
• Work on other activities and/or projects as requested by Management
• Maintain open communication with Percepta and Ford management
• Promotes and fosters a continuous improvement culture within the organization
• Plan and implement strategic learning objectives for self-development
• Communicate professional, grammatically correct verbal responses to customer concerns and inquiries
• Schedule and act as an OWS training resource specialist when requested by dealerships for platform session user experience
• Maintain master list of all Melbourne employees including adding new hires, adjusting for team movement, and tracking any attrition in the program
• Collaborate with Team Leads and Program Management on keeping any relevant trackers (attendance, corrective action, etc.) up to date
• Additional duties as tasked

• High School Diploma or equivalent
• Automotive Technical based degree from College or Technical/Vocational school or equivalent industry experience – preferred
• Minimum 2 years of experience as a Technical Service Representative II –…