Case Resolution Specialist

Qualifications:

• Minimum of 2+ years of recent case management or customer service experience with the ability to handle complex issues and maintain a service-oriented mindset.
• Experience in operations coordination, dispatch, or similar roles where managing multiple moving parts and stakeholders is required.
• Proficiency with Microsoft Office Suite, including Excel and Word, for data entry, documentation, and reporting.
• Strong written and verbal communication skills, with the ability to communicate clearly and professionally with providers, customers, and internal teams.
• Demonstrated critical thinking skills to understand, analyze, evaluate, and negotiate in complex situations.
• Detail-oriented approach with strong data entry and documentation skills to ensure accurate records and tracking.
• Ability to show an appropriate sense of urgency, especially when managing emergency and high-priority claims.
• High School Diploma or GED required.

Work EnvironmentThis role operates in a modern, brand-new office located in Naperville, featuring a pit-style layout with great energy on the floor, a contemporary kitchen area, and a soda machine. The facility also includes amenities such as a gym, basketball court, coffee shop, and convenience store, which become available upon transitioning to permanent employment. Training typically lasts 24 weeks, with hours from Monday through Friday, 8:00 a.m. to 4:30 p.m. After training, the schedule will be Tuesday through Saturday with shift options such as 8am to 4:30pm, 8:30am to 5pm, 9:00 a.m. to 5:30 p.m..Job DescriptionThis role is not a call center position. You will be handling a queue of cases. Responsibilities

• Manage daily interactions with network and non-network providers, ensuring claims are dispatched and handled promptly.
• Arrange appropriate providers to complete claims that cannot be automatically dispatched, including locating providers when no in-network options are available.
• Monitor and oversee service request hubs, including Need Provider, Emergency requests, and white glove items, to ensure timely action and resolution.
• Handle inbound and outbound phone calls with providers, customers, and internal teams, re-directing calls as needed and providing clear, professional communication.
• Respond promptly to email inquiries from customers, providers, and other departments regarding claim status and service requests.
• Process provider inquiries and assist with special handling claims, ensuring accurate documentation and appropriate follow-up.
• Perform provider paperwork and maintain provider profiles, including data entry, updates, and ongoing profile maintenance in company systems.
• Interpret contract language related to enrollments, contracts, and agreements with providers to ensure compliance and proper execution.
• Facilitate emergency and urgent work orders by coordinating closely with both customers and contractors to achieve swift resolution.
• Research contractors who are not currently under agreement and arrange one-time agreements to complete work orders when necessary.
• Negotiate with contractors to reach agreeable terms for unusual, inconvenient, or urgent work orders while balancing customer needs and business guidelines.
• Dispatch work orders according to established guidelines, ensuring accurate details and timely communication to providers.
• Generate requests using applicable forms and software, including systems such as Agent Desktop and CMS.
• Proactively review open claims and follow up with contractors on open work orders to drive them to completion.
• Prepare and respond to data requests and execute work orders, service orders, error reports, and set-ups in various system configurations.
• Document and track activities and requests thoroughly in company systems, maintaining accurate records of interactions and claim progress.
• Develop and nurture strong relationships with key vendors, customers, and internal team members to foster collaboration and trust.
• Engage daily with potential new provider leads and deliver impeccable support and communication to each individual.
• Follow all policies and procedures for daily tasks, ensuring compliance with operational and quality standards.
• Monitor emergency claims as they come in, track their progress through the entire process, and ensure they are worked and resolved quickly.
• Identify and contact providers in specific geographic areas, including searching and calling providers found via online tools, to assign claims efficiently.
• Provide overflow support to the broader Provider Support team as needed, contributing to workflow and queue management during busy periods.

Job Type & LocationThis is a Permanent position based out of Warrenville, IL. Pay and BenefitsThe pay range for this position is $23.00 - $24.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits

available for this temporary role may include the following:

Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave) Job Type & LocationThis is a Permanent position based out of Warrenville, IL. Application DeadlineThis position is anticipated to close on Nov 20, 2026. Workplace TypeThis is a hybrid position in Warrenville,IL.

About Aston Carter

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies. We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence. With offices across the U.S., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing® Platinum Award winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email astoncarteraccommodation@astoncarter.com for other accommodation options.

San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.

Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.