Claims Associate Representative

Title: Claims Associate Representative

Location: Remote Work from Home

Duration: 6 months

This position includes fiduciary duty or access to financial systems.

Must-Have

• Candidate must have an in-depth knowledge of accounts receivable and related function.
• Proficient in Microsoft Office Products (Word, Outlook, Excel).
• 2-4 years of 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.
  
  

Education and Experience:

• High school Diploma or GED 2 years minimum experience in medical billing and/or claims accounts receivable.
  
  

Duties:

• 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.
• 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 client 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 30-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.
  
  

Mandatory IT requirements for all candidates - This information is also included in the attachment.

• The minimum acceptable internet speed is 10mb download and 5mb upload.
• Please note that if the contractor's speed is right at or just above the minimum speeds and others in their home are using their network, their bandwidth will be compromised, and they will experience speeds below the minimum requirements. This will result in choppy or a complete loss of audio and video capabilities. An ISP speed upgrade is required in this scenario.
• The contractor must be able to hardwire their Ethernet cable from their work computer system into their modem.
• As a standard, IT will provide a 6' long Ethernet cord.
• IT may be able to provide up to a 20' Ethernet cord if they have them in stock. Please note the following:
• IT may not have 20' cables in stock to provide. Most often, they do not.
• If the contractor requires an Ethernet cable longer than 6', Client must be notified prior to shipping their equipment. Shipping generally occurs in the week before class starts. If IT does not have a 20' cable in stock, the contractor is expected to purchase it on their own and it must be available on their start date.
• Ethernet cords longer than 20' are discouraged, as they are known to cause connection issues with the Meraki. If a contractor needs an Ethernet cord longer than 20', they must purchase it on their own and it must be available on their start date. Ethernet cables longer than 50' are strongly discouraged and should not be used.
  
  

Workstation & Equipment:

• The contractors should have an appropriate workstation for their work equipment on their start date. They should have a desk and a chair that they are able to sit in for the duration of the day.
• Note: We acknowledge that some contractors may not have a traditional desk. They must have a space where they can sit comfortably for the day. We strongly discourage contractors from sitting on their couch, on the floor, etc., to learn and work, as this is not sustainable long term.
• The contractor must ensure that company provided computer equipment is protected from damage excluding normal wear and tear, e.g. children pulling cords or equipment, trip and falls over cords or equipment, food, and drink spills, etc.
  
  

Cpra

Notice to California Applicants: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.About Us: Established in 2004, SPECTRAFORCE® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRAFORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at: http://www.spectraforce.com

Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.

Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.