Sr Reconciliation Representative (Remote - $17/hr)

American Specialty Health Incorporated (ASH) is seeking an Sr Reconciliation Representative to join our Reconciliation department. The primary function of this position is to reconcile claims, including complex claims, for payment as per Explanation of Benefits from Health Plan Payors for 2-step accounts.

Requirements

• 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 which may include payment or underpayment.
• Notifies supervisors of trends related to invalid denials by TPAs or Health Plans.
• Documents comments in internal notes fields in IHIS in addition to spreadsheets being worked.
• Reviews and responds to ASHCore logs within 48 hours of assigned date.
• Meets department production and quality requirements.
• Maintains confidentiality of all claims documents, records, and claims related issues.
• Promotes a spirit of cooperation and understanding among all personnel.
• Attends organizational meetings and trainings as required.
• Attends department meetings.
• Adheres to organizational policies and procedures.
• Recognizes unique and/or problem situations within area of assigned responsibility. Researches and makes recommendations to Supervisor.
• Provides assistance and teamwork to Claims Department staff in accomplishment of routine duties and special projects.
• Performs other duties as assigned.
• Complies with all policies and standards.

Benefits

• Health Insurance
• Paid Time Off
• Retirement Plan