Sears Under Review
When a Sears Claim goes into an Under Review status in ServiceBench, a Task is created in Zoho and assigned to the National Client-Sears Queue. When working the Task, be sure to verify why the claim needs to be reviewed then follow the process to complete the task.
- In Zoho click Activities.
- Select My Open Tasks under Tasks.
- Click Tasks on the left Navigation Panel
- Locate My Open Tasks under All Views
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- Filter tasks by clicking the Ellipsis (...) button and sort by Created Date to show the oldest task first
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- My Open Tasks will only show tasks in an Open status. To view all tasks regardless of status, select My Tasks
- Click the Star next to My Open Tasks to add to your Starred Views (favorites)
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- Agents can also use the Kanban Dashboard to locate Tasks by clicking the Expand button on the Top Menu, selecting Kanban Task Board, then selecting My Tasks
- Once filtered (oldest on top), click the top Task to open.
- Copy the Claim Number/Service Job Number then swivel to ServiceBench.
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- Locate the Claim/Service Job in ServiceBench.
- Review the Service Job history and the Claim.
- Once all the required information is obtained, Approve or Reject the claim based on the findings.
- Notate the Service Job
- In Zoho the status will automatically update to Completed.
- If the Claim was Approved, the Claim Status will update to Approved and the Subject will now read Claims-Approved
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- Cinch Agents cannot approve claims with Customer Options or claims created by a Cinch Agent for Authorization. If the claim does not have a Sears Reference Number, it should not be Approved.
- If the Claim was Rejected, the Claim Status will update to Rejected and the Subject line will now read Claims-Rejected
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Sears Claim Escalations
When a Sears Admin enters an Escalation in the ServiceBench Claim, a Task is created in Zoho and assigned to the National Clients-Sears Queue. When working the Task, be sure to review the escalation reason then follow the process to complete the task.
- In Zoho click Activities.
- Select My Open Tasks under Tasks.
- Click Tasks on the left Navigation Panel
- Locate My Open Tasks under All Views
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- Filter tasks by clicking the Ellipsis (...) button and sort by Created Date to show the oldest task first
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- My Open Tasks will only show tasks in an Open status. To view all tasks regardless of status, select My Tasks
- Click the Star next to My Open Tasks to add to your Starred Views (favorites)
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- Agents can also use the Kanban Dashboard to locate Tasks by clicking the Expand button on the Top Menu, selecting Kanban Task Board, then selecting My Tasks
- Once filtered (oldest on top), click the top Task to open.
- Copy the Service Job Number.
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- Swivel to ServiceBench and locate the Service Job using the Service Job Number.
- Click the Claim hyperlink in ServiceBench.
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- Click the Escalations tab in the Claim.
- There will be an asterisk in the tab to show a new comment has been entered
- Review the Escalation Comment and resolve using the details provided.
- Escalation Comment will also show in the Zoho Comments
- Enter the Response Comment and click Save.
- Response Comment will sync to Zoho Comments
- In Zoho the status will automatically update to Completed.
- In the Main Task Layout, the following fields will also update:
- Escalation Responded By
- Escalation Responded Date
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Sears Rejects
When a Sears Claim is automatically rejected by the system or rejected by a Sears Admin, a Task is created in Zoho and assigned to the National Client-Sears Queue. When working the Task, be sure to review the rejection reason then follow the process to complete the task.
- In Zoho click Activities.
- Select My Open Tasks under Tasks.
- Click Tasks on the left Navigation Panel
- Locate My Open Tasks under All Views
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- Filter tasks by clicking the Ellipsis (...) button and sort by Created Date to show the oldest task first
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- My Open Tasks will only show tasks in an Open status. To view all tasks regardless of status, select My Tasks
- Click the Star next to My Open Tasks to add to your Starred Views (favorites)
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- Agents can also use the Kanban Dashboard to locate Tasks by clicking the Expand button on the Top Menu, selecting Kanban Task Board, then selecting My Tasks
- Once filtered (oldest on top), click the top Task to open.
- Copy the Claim Number/Service Job Number then swivel to ServiceBench.
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- Locate the Claim/Service Job in ServiceBench.
- Review the Claim to verify why it was Rejected.
- Once all the required information is obtained, Approve or Reject the claim based on the findings.
- Notate the Service Job
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- If the Claim should remain Rejected, the agent will need to click APPROVE OVERRIDE and Reject the claim again. This will send a notification back to Sears.
- In Zoho the status will automatically update to Completed.
- If the Claim was Approved, the Claim Status will update to Approved and the Subject will now read Claims-Approved
- If the Claim was Rejected, the Claim Status will update to Rejected and the Subject will now read Claims-Rejected
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Sears Incompletes
When a batch of Sears Claims are imported into ServiceBench but are missing required fields, the claim status updates to Incomplete. This will create a Task in Zoho which will be assigned to the National Client-Sears Queue. When working the Task, be sure to verify which fields are missing then follow the process to complete the task.
- In Zoho click Activities.
- Select My Open Tasks under Tasks.
- Click Tasks on the left Navigation Panel
- Locate My Open Tasks under All Views
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- Filter tasks by clicking the Ellipsis (...) button and sort by Created Date to show the oldest task first
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- My Open Tasks will only show tasks in an Open status. To view all tasks regardless of status, select My Tasks
- Click the Star next to My Open Tasks to add to your Starred Views (favorites)
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- Agents can also use the Kanban Dashboard to locate Tasks by clicking the Expand button on the Top Menu, selecting Kanban Task Board, then selecting My Tasks
- Once filtered (oldest on top), click the top Task to open.
- Copy the Claim Number/Service Job Number then swivel to ServiceBench.
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- Locate the Claim/Service Job in ServiceBench.
- Review the Incomplete Claim to verify which Required Fields are missing information.
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- Click SAVE AS NEW CLAIM in ServiceBench and Approve the new claim with all Required Fields entered.
- All claim information in the previous claim will transfer over to the new claim
- The status of the Incomplete Claim will update to Corrected.
- The Claim Status will sync to Zoho in the Main Task Layout
- In Zoho the status will automatically update to Completed.
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Claim Error Message
In some instances, the Agent may receive an error message when attempting to Reject, Approve, or Correct a claim. If this happens, follow the process to complete the task.
- Process a New Claim in ServiceBench.
- Notate the Service Job.
- Swivel to Zoho and manually update the task to Completed.
- The Claim Status in the Main Task Layout will remain as is
Reopen a Zoho Task
When a Claim is missing information that is needed for Approval, follow the process to complete the task.
- Manually Reject the Claim in ServiceBench.
- Send a request to Sears for additional information.
- Once the updates are received, locate the Completed-Rejected task in Zoho.
- Click Re-open Task.
- Swivel to ServiceBench to update the Service Job and the Claim.
- Approve the Claim.
- In Zoho the status will automatically update to Completed.
- The Claim Status will sync to Zoho in the Main Task Layout