Onsite Claims Reconciliation Specialist

American Specialty Health Incorporated; San Diego (CA); On-site; USD 21,000 - 23,000; Full time

Job summary

American Specialty Health Incorporated (ASH) is seeking a Reconciliation Representative to join our Claims department. The primary function is to reconcile claims for payment per Explanation of Benefits from Health Plan Payors for 2-step accounts.

This onsite, full-time role involves handling 2-step claims, reviewing EOBs, and communicating with Health Plans to ensure accurate payments. The position requires a High School Diploma or GED and at least 2 years of claims processing experience, with

Qualifications

• High School Diploma or GED certificate required.
• 2 years with claims processing, computer, typing, 10-key, and telephone skills required.
• Knowledge of Microsoft Word and Excel helpful.
• Familiarity with Managed Care, HMO, PPO health plan provisions.
• Excellent listening and interpersonal communication skills to identify core competencies.

Responsibilities

• Reconciles, resolves, and researches 2-step claims and payments to ASH.
• Mails, scans, and tracks EOBs and health plan letters.
• Manually reconciles claims for payment from paper EOBs or spreadsheets.
• Contacts Health Plans to check claim status or reprocess denied claims.
• Uses Health Plan/TPA websites to check on claim status or reconcile claims.
• Maintains confidentiality and meets production/quality requirements.

Skills

Claims processing

Typing

10-key

Telephone skills

Microsoft Word

Microsoft Excel

Interpersonal communication

Listening skills

Education

High School Diploma or GED

Job description

American Specialty Health Incorporated (ASH) is seeking a Reconciliation Representative to join our Claims department. The primary function is to reconcile claims for payment per Explanation of Benefits from Health Plan Payors for 2-step accounts.

This onsite, full-time role involves handling 2-step claims, reviewing EOBs, and communicating with Health Plans to ensure accurate payments. The position requires a High School Diploma or GED and at least 2 years of claims processing experience, with