Claims Associate Representative

This is a fully remote position, open to applicants in United States.

📋 Description

• Assess, analyze, and manage accounts receivable claims promptly and accurately.

• Explore denied, delayed, or underpaid claims, pinpoint root causes, and implement corrective measures.

• Engage in outbound communications with third-party payers, providers, and internal teams to resolve claim-related matters.

• Record all claim activities and uphold thorough documentation in alignment with organizational standards.

• Track claim statuses and ensure timely follow-ups for resolution and payment.

• Refer complex claims or unresolved issues to senior representatives or management as needed.

• Maintain a comprehensive understanding of payer policies, compliance regulations, and company procedures.

• Conduct thorough reviews of outstanding balances associated with claims.

• Apply sound judgment when processing claims with outstanding balances.

⛳️ Requirements

• High school diploma or GED.

• A minimum of 2 years of experience in medical claims handling and/or accounts receivable.

• At least 2 years of experience in reconciliation, with strong analytical skills and the ability to interpret EOBs/EOPs, is highly preferred.

• Proficient in Microsoft Office Suite (Word, Outlook, Excel) is required.

• Capable of working independently and collaboratively within a team is essential.

• Highly detail-oriented with strong planning and organizational skills is required.

• Ability to thrive in a fast-paced environment is a must.

• Strong time management and documentation abilities.

• Competence in performing basic mathematical calculations is required.

• A high level of precision and attention to detail is essential.

• For remote work, internet service must be provided through a cable broadband or fiber optic provider with a minimum of 10Mbps download and 5Mbps upload speeds.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits begin on the first day of employment.

• Access to well-being and behavioral health programs starting on day one.

• 401(k) plan available.

• Company-sponsored life insurance.

• Tuition reimbursement opportunities.

• A minimum of 18 days of paid time off each year.

• Paid holidays.

• Options for leaves of absence.

• Remote or home-based work options available.

• Requirement for cable broadband or fiber optic internet for home-based work.