Resolution Specialist - Lehi, UT
18 hours ago
Job description
Join a thriving organization known for its strong culture, commitment to growth, and collaborative environment. Build your expertise in a role that values precision and professional development while contributing to meaningful outcomes for homeowners nationwide. Advance your career within a stable enterprise that prioritizes performance, accountability, and continuous improvement.
Primary Services is excited to announce the role of
Resolution Specialist
for a large, nationally recognized organization within the energy industry. This enterprise-level company supports thousands of customers nationwide and offers structured career progression, operational excellence, and a performance-driven culture. The
Resolution Specialist
will play a critical role in the claims adjudication lifecycle by interpreting contract language, validating coverage obligations, and ensuring accurate and timely claim resolution.
Responsibilities
- Respond to a high volume of claim authorization requests professionally and efficiently.
- Analyze claim eligibility by evaluating diagnoses, product details, service history, tenure, and applicable terms and conditions.
- Interpret and apply contract language to determine coverage qualification and liability.
- Capture product failures and document recommendations to support adjudication decisions.
- Process cash settlement offers and contractor dispatch requests in alignment with established guidelines.
- Enforce contractor pricing agreements and ensure cost compliance.
- Communicate claim determinations and coverage outcomes clearly to homeowners.
- Adhere to call center performance standards and quality assurance metrics.
- Execute timely follow-ups to ensure claims progress to resolution.
- Partner with cross-functional departments to support accurate claim closure.
- Provide escalation support and subject matter expertise on complex or sensitive claims.
- Analyze existing coverage and identify opportunities for appropriate add-on plans to maximize customer benefits.
Qualifications
- High school diploma or equivalent required; bachelor's degree preferred.
- 2–4 years of experience in claims authorization, claims adjudication, insurance operations, or high-volume contact center environments.
- Demonstrated experience interpreting contractual terms and conditions.
- Working knowledge of claims processing systems and case management platforms.
- Proficiency in Microsoft Excel, Word, and PowerPoint.
- Experience handling high-volume workloads within defined service level agreements.
- Familiarity with contractor dispatch coordination and pricing agreement enforcement preferred.
- Experience processing settlements and coverage determinations.
- Background in upselling or cross-selling service plans within regulated environments preferred.
This role offers long-term stability, exposure to complex claim scenarios, and the chance to influence customer outcomes in a structured, growth-oriented organization.
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