Claims Associate Representative

Title: Claims Associate Representative
Location: 100% Remote - Work at Home
Hours: Mon - Fri 8 AM - 5 PM CST
Initial Assignment Length: 5 Months (Extension is possible based on performance, attendance, and business need)
Benefits: Paid weekly, health, dental + vision insurance available!
A global health insurance provider whose mission is to improve the health, well-being, and peace of mind of those the company serves. Become a part of this ever-growing, deeply caring, and collaborative healthcare industry leader today!
Responsibilities:
This position includes fiduciary duty or access to financial systems.
The Accounts Receivable Processor will be responsible for all facets of accounts receivable to ensure a complete review of outstanding accounts receivable with a strong concentration in revenue cycle management. The Accounts Receivable claim examiner must have a thorough knowledge of government, commercial, and other types of insurance billing guidelines in multiple states to demonstrate effective judgment when processing all claims with outstanding balances.
Other responsibilities include:

• Research/rectify third party denials/edits, requests for information and other related correspondence
• Process a variety of Third Party Administrator (TPA) payments
• Willingness to learn different claim platforms within eviCore and also client claims platforms when necessary
• Analyzes and clears payment variances
• Verify patients' eligibility, coverage, and benefits and identify authorization requirements relates to working aged AR.
• Follow-up on outstanding account balances at 30-days from the date of service in accordance with client and organizational protocol with an emphasis on maximizing client satisfaction and provider profitability.
• Process timely premium payments to providers
• Research and answer accounts receivable discrepancies
• Monitors payer responses, and other software as necessary to ensure prompt payment

Skills:

• Candidate must have an in-depth knowledge accounts receivable and related functions
• Proficient in Microsoft Office Products (Word, Outlook, Excel)
• Do not submit any workers who cannot perform multi step, complex functions within Microsoft Office.
• 2-4 years claims handling and accounts receivable experience
• Can work both independently and collaboratively with a team
• Highly oriented to detail, planning and organizing skills
• Ability to work in a fast paced environment
• Time management and documentation skills
• Ability to perform basic mathematics calculations
• Exceptional reconciliation, analytic skills, and the ability to interpret EOBs/EOPs
• A high level of accuracy and attention to detail and have a dedicated approach to work

Education:

• High school Diploma or GED
• 2 year minimum experience in medical billing and/or claims accounts receivable

Languages:

• English Read Write Speak