Claims Associate Representative

Job title:nbsp;Claims Associate Representative
Duration: nbsp;5+ Months (Possibility of extension depending upon business requirements and performance)
Location: 100% Remote

Job description:
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 clientnbsp;and also client claims platforms when necessary
• Analyzes and clears payment variances
• Verify patients#39; 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

nbsp; Duties:

• Delivers basic technical, administrative, or operative Claims tasks.
• Examines and processes paper claims and/or electronic claims.
• Completes data entry, maintains files, and provides support.
• Understands simple instructions and procedures.
• Performs Claims duties under direct instruction and close supervision.
• Work is allocated on a day-to-day or task-by-task basis with clear instructions.
• Entry point into professional roles.

Qualifications:

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

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Requirements:

• High school Diploma or GED nbsp;
• 2 year minimum experience in medical billing and/or claims accounts receivable

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