ESP Prior Approval Escalation Specialist

Percepta•Melbourne, FL

About The Position

At Percepta, we bring first-class service across each market we support. As a 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 What You’ll Be Doing 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.

Requirements

High School Diploma or equivalent
Minimum 2 years of experience as a Technical Service Representative II – required
Previous experience mentoring technical service representatives
Experience managing client interactions
Strong customer service background and experience
Strong customer service skills, with a commitment to quality and customer satisfaction
Strong oral and written communication skills, with ability to persuade and sell using a business case
Advanced analytical skills with ability to interpret existing data to suggest resolution
Strong problem solving and decision making skills
Creative and forward thinking. Seeks opportunities for innovation and continuous improvement
Strong time management, organizational and planning skills, able to prioritize, multitasks, adapt and thrive in a fast paced, results-driven environment
Self-starter, who demonstrates initiative, resourcefulness and ability to work independently
Quick learner, with a desire and interest in learning new information
Ability to build relationships with Team Leaders, Customer Care Representatives, Regional and Dealer management and adapt approach to different management styles
Facilitation skills and leadership skills. Capable of effectively facilitating meetings and developing and delivering presentations
Must represent Percepta professionally with all clients and external organizations and contacts
Ability to analyze repair shop claim information to determine contract coverage
Ability to speak confidently about extended service business products and prior approval process
Ability to utilize web based technical service information to complete the claim adjudication process
Excellent interpersonal skills in a team environment
Communicate and articulate in an effective manner both verbally and written
Strong working knowledge of the Internet, computers, and software (MS Office products, Internet Explorer, etc.)
Flexibility and adaptability in a fast-paced environment
Ability to exercise independent judgment and decision making
Reasoning ability and logical thinking
Training and development aptitude

Nice To Haves

Automotive Technical based degree from College or Technical/Vocational school or equivalent industry experience – preferred
Automotive OEM and/or Automotive Dealership experience preferred

Responsibilities

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; BlueBird Bus by validating and reconciling claims versus OWS submissionValidate 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 SafeGuard 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