Client Resolution Specialist

Who Is Accuserve:

Accuserve is a Managed Repair Experience Company, unifying and humanizing the experience for people simply trying to take care of the things they treasure most. As an integrated community of restoration experts, we're redefining how smart, unified, and human the experience can be to fix what matters most to people in extreme times of need. We are builders, innovators, community leaders, facilitators, connectors, dreamers, keepers, mothers, fathers, sisters, and brothers. We're human too and know what it means to take care of you and your property.

Job Summary:

Serves as the primary point of contact within our managed repair program to support our clients, the insurance carriers we partner with, when new issues or complaints are submitted. Investigates and attempts to resolve complaints quickly for the client and their policyholders in a manner that’s fair and appropriate for all stakeholders. Involves significant investigation and collaboration with our Operations and Vendor Network teams, plus working directly with policyholders and/or vendors involved in specific files of concern. Through the strength of sound judgment, experience, and expertise, our Client Services team can influence client’s perspectives, views, and decision-making regarding program level issues and conflict resolution. 

General Responsibilities:

• Investigate concerns and disputes made against network vendors, including allegations of workmanship defects, service level agreement (SLA) failures, customer service issues, and contractual non-compliance
• Analyze facts, contractual obligations, service agreements, and program guidelines to determine responsibility, liability, and appropriate resolution
• Grant authority for process management decisions, including contractual and approved extra-contractual payments required to resolve concerns, disputes, or program-level issues within assigned authority limits
• Evaluate damages, refund requests, and settlement demands to determine appropriate payment amounts consistent with company policy, client contracts, and financial authority
• Negotiate resolutions between contractors, insureds, carriers, clients, and internal stakeholders to achieve timely, fair outcomes in the best interest of the company and its clients
• Escalate complex, high-exposure, or authority-exceeding matters and provide recommendations to senior management, sales leadership, or legal partners as appropriate
• Create, document, and maintain comprehensive files, including investigation notes, correspondence, supporting documentation, and settlement rationale
• Monitor files, metrics, and reports to ensure adherence to company procedures, service standards, compliance requirements, and client expectations
• Identify coverage issues, policy interpretation concerns, or contractual ambiguities and collaborate with leadership to resolve them
• Develop and implement best practices for dispute resolution, vendor accountability, and file handling efficiency
• Provide training, mentoring, and coaching to team members on file handling, investigation techniques, documentation standards, and non-defensive communication strategies
• Assist in the development of training materials and procedural guides related to file handling, vendor disputes, and client communication
• Coordinate and manage information flow between clients, vendors, internal departments, and leadership to ensure transparency and timely resolution
• Serve as a primary point of contact for client inquiries related to file status, dispute outcomes, and program trends
• Participate in monthly client meetings, business reviews, and on-site visits as required, including travel when necessary
• Assist with meeting preparation, reporting, and event planning for existing and prospective clients
• Collect, analyze, and trend data and dispute data to identify root causes, recurring issues, vendor performance gaps, and process improvement opportunities
• Recommend and support operational, procedural, or vendor management changes to reduce future disputes
• Ensure compliance with applicable regulations, contractual obligations, and internal governance standards
• Perform other duties assigned to support client satisfaction, program performance, and organizational goals

Minimum Qualifications:

• Bachelor’s degree and/or 2-5 years of insurance file handling, dispute resolution, or adjuster experience.
• Working knowledge of contracts, service agreements, and SLA’s.
• Experience investigating and resolving multiparty disputes. 
• Understands file handling & Decision-Making related to insurance carrier processes and procedures
• Demonstrated ability to independently investigate files and make decisions within assigned authority limits
• Experience evaluating damages, refunds, or settlement requests and documenting rationale
• Ability to prioritize and manage a file inventory while meeting service-level timelines
• Strong written and verbal communication skills. 
• Proven negotiation and conflict resolution skills.
• Customer-focused mindset with the ability to balance fairness, cost control, and contractual compliance
• Proficiency with claims management systems and Salesforce
• Strong documentation and file management discipline
• Adjuster license in one or more states (or ability to obtain if required) is preferred.
• TPA, carrier, or vendor network experience
• Commercial liability, warranty, or service contract claims experience
• Experience presenting data trends and data to clients or leadership
• Sound judgment and confidence making decisions
• Comfortable escalating issues and recommending solutions to leadership
• Ability to work dynamically and adjust/modify approach to tasks; “meet the circumstances” and solve the critical business need
• Responsive, prompt and articulate; ability to communicate effectively internally and externally with clients 
• Detailed oriented and disciplined in their work approach 
• Resourcefulness, self-starting work habits, creativity in problem solving based on information and judgment
• Ability to work with minimum assistance and supervision is required
• Ability to work a flexible schedule during high volume and CAT events
• Knowledge of account management practices, insurance practices, and water mitigation
• Ability to review assigned carrier files and data and identify potential issues to resolve early in the life cycle
• Escalate known issues to the carrier and provide invoice and scope resolution with minimal supervision
• Ability to utilize technological devices, software and applications, previous experience with Microsoft Office Suites and basic computer skills required. 
• Reliable high speed home broadband internet connection with minimum 25 meg download and 10 meg upload speeds and ability to connect to home internet via ethernet cord is required if working remotely

Accuserve’s Human Centric Value Proposition:

Accuserve is built on a foundation of community, fostering valuable connections, and creating an innovative approach to help you navigate the insurance landscape. Built on culture, grounded in compassion.

Accuserve Values:

Communicating and Connecting, Doing the Right Thing, Compassionately Serve, courageously making an Impact and Staying Curious.