Claims Associate Representative

Remote Work from Home, United States

This position includes fiduciary duty or access to financial systems. Please review the attachment thoroughly.

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 -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

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.

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

EEO :