Unlock Your Potential as a Senior Reconciliation Representative
American Specialty Health Incorporated, a leading innovator in the healthcare industry, is seeking a highly skilled and experienced Senior Reconciliation Representative to join our dynamic Reconciliation department. As a remote worker, you'll enjoy the flexibility and freedom to work from the comfort of your own home, while making a significant impact on our organization's success.
About American Specialty Health Incorporated
American Specialty Health Incorporated is a renowned healthcare company that specializes in providing innovative solutions for health plans and their members. With a strong commitment to delivering exceptional customer service and a passion for improving healthcare outcomes, our company has established itself as a leader in the industry. As a Senior Reconciliation Representative, you'll be an integral part of our team, working collaboratively with other professionals to drive success and achieve our goals.
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 any discrepancies or issues.
- Utilize Health Plan and TPA websites to check on claim status, reconcile claims, and identify trends or patterns.
- Reconcile claims from various reports, including 14-day reports, aged reports, unreconciled reports, and rejected reports, to ensure timely and accurate claims resolution.
- Notify supervisors of trends related to invalid denials by TPAs or Health Plans, providing insights and recommendations for process improvements.
- Document comments and updates in internal notes fields in IHIS and spreadsheets, maintaining accurate and up-to-date records.
- Review and respond to ASHCore logs within 48 hours of assigned date, ensuring timely and effective issue resolution.
- Meet department production and quality requirements, demonstrating a commitment to excellence and continuous improvement.
- Maintain confidentiality of all claims documents, records, and claims-related issues, adhering to organizational policies and procedures.
- 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 on industry developments and best practices.
- Recognize unique and/or problem situations within area of assigned responsibility, researching and making recommendations to Supervisor.
- Provide assistance and teamwork to Claims Department staff in accomplishment of routine duties and special projects, demonstrating a collaborative and supportive approach.
Qualifications and Requirements
To be successful as a Senior Reconciliation Representative, you'll need to possess the following essential qualifications:
- High School diploma or equivalent required.
- 2 to 3 years of experience in claims processing, with a strong understanding of computer, typing, 10-key, and telephone skills.
- Knowledge of Microsoft Word and Excel, with the ability to learn and adapt to new software and systems.
- Familiarity with Managed Care, HMO, PPO health plan provisions, and a strong understanding of healthcare industry trends and developments.
- Excellent listening and interpersonal communication skills, with the ability to identify critical core competencies based on success factors and organizational environment.
In addition to these essential qualifications, we prefer candidates with:
- Strong analytical and problem-solving skills, with the ability to analyze information, identify patterns, and develop effective solutions.
- Excellent customer service skills, with a commitment to meeting the needs and expectations of both internal and external customers.
- Ability to effectively organize, prioritize, multi-task, and manage time, with a strong focus on productivity and efficiency.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions, with a strong attention to detail and commitment to quality.
Core Competencies
To excel as a Senior Reconciliation Representative, you'll need to possess the following 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, with the ability to identify critical core competencies based on success factors and organizational environment.
- Ability to effectively organize, prioritize, multi-task, and manage time, with a strong focus on productivity and efficiency.
- Demonstrated accuracy and productivity in a changing environment with constant interruptions, with a strong attention to detail and commitment to quality.
- Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
- Ability to exercise strict confidentiality in all matters, adhering to organizational policies and procedures.
Work Environment and Company Culture
As a remote worker, you'll be working from the comfort of your own home, with the flexibility and freedom to create a work environment that suits your needs. Our company culture values collaboration, innovation, and teamwork, with a strong commitment to delivering exceptional customer service and improving healthcare outcomes.
Compensation and Benefits
We offer a competitive salary and a comprehensive benefits package, including opportunities for career growth and professional development. As a Senior Reconciliation Representative, you'll have the opportunity to make a significant impact on our organization's success, while enjoying a fulfilling and rewarding career.
Career Growth Opportunities
At American Specialty Health Incorporated, we're committed to helping our employees grow and develop in their careers. As a Senior Reconciliation Representative, you'll have opportunities to:
- Develop your skills and expertise in claims processing and reconciliation.
- Take on additional responsibilities and contribute to special projects.
- Collaborate with other professionals to drive success and achieve our goals.
- Participate in training and development programs to stay up-to-date on industry trends and best practices.
Why Join Our Team?
If you're a motivated and experienced professional looking for a challenging and rewarding career opportunity, we encourage you to apply for this Senior Reconciliation Representative role. As a member of our team, you'll enjoy:
- A flexible and remote work environment.
- A competitive salary and comprehensive benefits package.
- Opportunities for career growth and professional development.
- A collaborative and inclusive company culture.
- The chance to make a significant impact on our organization's success.
How to Apply
If you're ready to take the next step in your career and join our dynamic team, please submit your application today. We can't wait to hear from you!
American Specialty Health Incorporated is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
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