Join American Specialty Health Incorporated as a Sr Reconciliation Rep and Drive Success in a Dynamic Remote Work Environment
American Specialty Health Incorporated, a leading innovator in the healthcare industry, is seeking an experienced and skilled Senior Reconciliation Representative to join our Reconciliation department. As a remote worker, you will have the flexibility to work from home and be part of a collaborative team that values innovation, teamwork, and exceptional customer service. This is an exciting opportunity to leverage your expertise in claims processing, communication, and problem-solving to drive success in a fast-paced environment.
About Our Company and the Role
American Specialty Health Incorporated is a dynamic organization that is committed to delivering high-quality services to its clients. Our Reconciliation department plays a critical role in ensuring that claims are processed accurately and efficiently. As a Senior Reconciliation Representative, you will be responsible for reconciling complex claims, resolving payment issues, and communicating with Health Plan Payors to ensure timely and accurate payment.
Key Responsibilities
- Reconcile, resolve, and research 2-step claims and payments to ASH, ensuring accuracy and efficiency in claims processing.
- Manually reconcile claims for payment from Health Plan Payors received by paper EOBs or spreadsheets, utilizing strong analytical and problem-solving skills.
- Make calls to Health Plans to check the status of claims, request reprocessing of denied claims, and resolve payment issues, demonstrating excellent communication and interpersonal skills.
- Use Health Plan and TPA websites to check on claim status or reconcile claims, staying up-to-date with the latest technology and systems.
- Reconcile claims from various reports, including 14-day reports, aged reports, unreconciled reports, and rejected reports, to identify trends and areas for improvement.
- Notify supervisors of trends related to invalid denials by TPAs or Health Plans, providing insights and recommendations for process improvements.
- Document comments in internal notes fields in IHIS and maintain accurate spreadsheets, ensuring data integrity and confidentiality.
- Review and respond to ASHCore logs within 48 hours of assigned date, demonstrating a commitment to timely and effective communication.
- Meet department production and quality requirements, consistently delivering high-quality results in a fast-paced environment.
- Maintain confidentiality of all claims documents, records, and claims-related issues, upholding the highest standards of data security and integrity.
- Promote a spirit of cooperation and understanding among all personnel, fostering a positive and inclusive work environment.
- Attend organizational meetings and trainings as required, staying up-to-date with industry developments and best practices.
- Adhere to organizational policies and procedures, ensuring compliance with regulatory requirements and company standards.
- Recognize unique and/or problem situations within the area of assigned responsibility, researching and making recommendations to supervisors to drive process improvements.
- Provide assistance and teamwork to Claims Department staff in the accomplishment of routine duties and special projects, demonstrating a collaborative and supportive approach.
Essential and Preferred Qualifications
To be successful in this role, you will need:
- A High School diploma or equivalent.
- 2 to 3 years of experience in claims processing, with a strong understanding of health plan provisions, including Managed Care, HMO, and PPO.
- Proficiency in Microsoft Word and Excel, with the ability to learn new systems and technologies.
- Excellent listening and interpersonal communication skills, with the ability to identify critical core competencies based on success factors and organizational environment.
- Strong analytical and problem-solving skills, with the ability to analyze information, problems, issues, and situations to develop effective solutions.
Core Competencies
The ideal candidate will possess:
- A demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
- Excellent customer service skills, with the ability to meet the needs and expectations of both internal and external customers.
- The ability to effectively organize, prioritize, multi-task, and manage time, with a proven track record of productivity and accuracy in a fast-paced environment.
- A commitment to confidentiality and data security, with the ability to exercise strict confidentiality in all matters.
- A flexible and adaptable approach, with the ability to respond to changing priorities and deadlines.
Career Growth Opportunities and Learning Benefits
At American Specialty Health Incorporated, we are committed to supporting the career growth and development of our employees. As a Senior Reconciliation Representative, you will have opportunities to:
- Develop your skills and expertise in claims processing, communication, and problem-solving.
- Take on additional responsibilities and contribute to special projects, driving process improvements and innovation.
- Participate in training and development programs, staying up-to-date with industry developments and best practices.
- Collaborate with colleagues and leaders to drive business outcomes and achieve company goals.
Work Environment and Company Culture
As a remote worker, you will have the flexibility to work from home in a designated work area with company-provided technology equipment. Our company culture values:
- Innovation and teamwork, with a commitment to collaboration and mutual support.
- Exceptional customer service, with a focus on meeting the needs and expectations of our clients.
- Diversity and inclusion, with a commitment to creating a welcoming and inclusive work environment.
- Professional growth and development, with opportunities for training, education, and career advancement.
Compensation, Perks, and Benefits
We offer a competitive hourly rate of $17/hour, commensurate with experience. Our benefits package includes:
- A comprehensive compensation package, with opportunities for bonuses and incentives.
- A flexible and dynamic work environment, with the ability to work from home and achieve a healthy work-life balance.
- Opportunities for professional growth and development, with training and education programs to support your career goals.
- A collaborative and supportive team, with a commitment to mutual respect and teamwork.
Are You the One We're Looking For?
If you are a motivated and experienced professional with a passion for claims processing, communication, and problem-solving, we encourage you to apply for this exciting opportunity. As a Senior Reconciliation Representative at American Specialty Health Incorporated, you will have the chance to drive success in a dynamic remote work environment, develop your skills and expertise, and contribute to a collaborative and innovative team. Apply now and join our team!
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