Senior Claims Reconciliation Specialist (Remote)

American Specialty Health Incorporated; San Diego (CA); Remote; USD 60.000 - 90.000; Vollzeit

Benefits dieser Stelle

Company-provided equipment

Remote work from home

Zusammenfassung

American Specialty Health Incorporated (ASH) is seeking a Sr Reconciliation Representative to join our Claims department. The role focuses on reconciling, resolving, and researching 2-step claims for payment per EOBs from Health Plan Payors.

The position supports remote work from home with company-provided equipment and requires strong accuracy, communication, and collaboration within the Claims team.

Qualifikationen

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

Aufgaben

• Reconciles, resolves, and researches 2-step claims and payments to ASH.
• Manually reconciles claims for payment from Health Plan Payors received by paper EOBs or spreadsheets.
• Makes calls to Health Plans to check status of claims and requests reprocessing if denied in error.
• Uses Health Plan and TPA websites to check claim status or reconcile claims.
• Maintains confidentiality and meets department production and quality requirements.

Kenntnisse

Customer service

Interpersonal communication

Attention to detail

Time management

Teamwork

Ausbildung

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

Jobbeschreibung

American Specialty Health Incorporated (ASH) is seeking a Sr Reconciliation Representative to join our Claims department. The role focuses on reconciling, resolving, and researching 2-step claims for payment per EOBs from Health Plan Payors.

The position supports remote work from home with company-provided equipment and requires strong accuracy, communication, and collaboration within the Claims team.