ESP Prior Approval Escalation Specialist
ESP Prior Approval Escalation Specialist 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. During a Typical Day, You’ll •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 What You Bring to the Role •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 – required •Previous experience mentoring technical service representatives •Experience managing client interactions •Strong customer service background and experience •Automotive OEM and/or Automotive Dealership experience preferred What You Can Expect •Competitive Salary with Incentives •Health/Dental/Vision/Life Insurance •Flexible Spending Account (FSA) and Health Savings Account (HSA) •401(k) with company match •Vacation/Sick Time and Paid Holidays •Tuition Reimbursement •Employee Assistance Program •Employee Discount Program •Training and Development Programs (Percepta College) •Employee Rewards Program (Perci Perks) A Bit More About Your Role •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 About Percepta Established in 2000 as a joint venture with TTEC, Percepta has specialized in creating customer loyalty to its clients across the globe. Delivered in multiple channels, speaking multiple languages, we bring first-class service across each market we support. Our values are the heartbeat of our organization, and we live, breathe, and play by them daily. At Percepta, we: Lead with humility – We listen first, lead with empathy, and stay grounded—so people and ideas have room to grow. Service beyond self – We serve others—clients, customers, and teammates—with care and integrity in every interaction. Leave it better – We take ownership and leave every process, person, and place better than we found it. Win together – We succeed as one—celebrating, supporting, and showing up for each other. Deliver remarkable – We go beyond expectations to create bold, meaningful moments that stand out. Percepta is proud to be an equal opportunity employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Percepta embraces and is committed to building a diverse and inclusive workforce that respects and empowers the culture and perspectives within our global teams. We strive to reflect the communities we serve by not only delivering amazing service and technology, but also humanity. We make it a point to make sure all our employees feel valued and comfortable being their authentic selves at work. As a global company, we know diversity is our strength. It enables us to view projects and ideas from different vantage points and allows every individual to bring value to the table in their unique way. LI-remote LI-hybrid LI-onsite Percepta requires all employees hired in the United States to successfully pass a background check and depending on location and client program a drug test, as a condition of employment. Percepta is an Equal Opportunity Employer.
