Rejections Agent RPMG

Job Summary:

The Rejections Agent within RPMG is responsible for reviewing, processing, and resolving rejected transactions or cases in accordance with established guidelines and quality standards.

This role plays a critical part in ensuring operational accuracy, compliance, and timely resolution of exceptions within the workflow.

Key Responsibilities:

• Maintain 8 hours of daily production output, meeting or exceeding established productivity targets.
• Review and analyze rejected cases or transactions to determine root causes and appropriate resolutions.
• Process rejections in accordance with Lumexa procedures, policies, and compliance requirements.
• Meet or exceed the daily productivity target of 115 rejections per day.
• Ensure high levels of accuracy and attention to detail when handling cases.
• Identify recurring issues or trends in rejections and escalate when necessary.
• Participate in quality audits and implement feedback to maintain performance standards.
• Supported continuous process improvement by providing feedback on rejection patterns and system issues.

Quality & Compliance:

• Maintain a minimum QA score of 98% or higher (or per current quality benchmark).
• Ensure all charges meet quality standards.
• Adherent to company policies, client requirements, and regulatory standards.

Collaboration & Communication:

• Maintain effective communication with leadership and coworkers.
• Participate in team huddles, training, and process updates.
• Provide support during high-volume periods and contribute to team productivity goals

Qualifications:

• Previous experience in data processing, operations, claims, transaction review or rejections is an advantage.
• Strong attention to detail with a focus on accuracy and quality assurance.
• Familiarity with SLA-driven environments and time-sensitive workflows.
• Strong analytical and problem-solving skills to identify root causes of rejections.
• Basic understanding of compliance, policies, and procedural guidelines.
• Effective communication skills for collaborating with internal teams and escalating issues.
• Ability to manage time efficiently and prioritize tasks in a fast-paced environment.