Job Description
Senior Reconciliation Representative (Remote, $17/hour)
Claims
Remote, United States
Description
American Specialty Health is looking for an experienced and proficient Reconciliation Representative. This position reconciles resolves, and researches claims, including complex claims, for payment.
Remote Worker Considerations
Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment.
Responsibilities
- Reconciles, resolves, and researches ASO payments to ASH.
- System reconciles ASO claims payment from Health Plan Payors.
- Makes calls to Health Plans to check status of payment or underpayment. Make courtesy calls to Providers as needed
- Makes calls and researches overpayment requests from health plan recovery services.
- Documents follow-up in Reconciliation System or Communication Log.
- Prepares letters of explanation to Health Plans and prepares spreadsheet documentation of payments/overpayments/underpayments.
- Completes check requests for reimbursements of overpayments to Health Plans.
- Maintains confidentiality of all claims documents, records, and claims related issues.
- Promotes a spirit of cooperation and understanding among all personnel.
- Recognizes unique and/or problem situations within area of assigned responsibility. Researches and makes recommendations to Supervisor.
Qualifications
- High School diploma required.
- 2 to 3 years with claims processing, computer, typing, 10 key and telephone skills preferred.
- 1-2 years experience as a Reconciliation Representative preferred.
- Knowledge of Microsoft Word and Excel helpful.
Core Competencies
- Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
- Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
- Ability to effectively organize, prioritize, multi-task and manage time.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions.
- Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters.
Mobility
- Primarily sedentary, able to sit for long periods of time.
Physical Requirements
- Ability to speak, see and hear other personnel and/or objects. Ability to communicate both in oral and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard. Ability to lift up to 10 lbs.
Environmental Conditions
- Work-from-home (WFH) environment.