Claims Associate Representative

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

📋 Description

• Timely and accurate review, research, and processing of accounts receivable claims.

• Investigate claims that are denied, delayed, or underpaid, identify root causes, and implement corrective measures.

• Engage in outbound calls with third-party payers, providers, and internal departments to resolve issues related to claims.

• Maintain thorough documentation of all claim activities and keep detailed records in accordance with organizational standards.

• Monitor the status of claims and follow up to ensure swift resolution and payment.

• Escalate complex claims or unresolved issues to senior representatives or management when needed.

• Retain a strong understanding of payer policies, compliance requirements, and company procedures.

• Conduct a comprehensive review of outstanding balances related to claims and apply effective 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 with reconciliation and analytical skills, with a preference for those who can interpret EOBs/EOPs.

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

• Ability to work independently as well as part of a team is essential.

• Strong attention to detail, along with planning and organizational skills, is required.

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

• Excellent time management and documentation skills.

• Competence in performing basic mathematical calculations is required.

• A high level of accuracy and attention to detail is necessary.

• If working remotely, a cable broadband or fiber optic internet service with a minimum of 10 Mbps download and 5 Mbps upload is mandatory.

🏝️ Benefits

• Eligibility for an annual bonus plan.

• Medical, vision, and dental benefits starting from day one.

• Access to well-being and behavioral health programs.

• Participation in a 401(k) plan.

• Company-paid life insurance.

• Tuition reimbursement opportunities.

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

• Paid holidays.

• Leaves of absence available.

• Option for a remote work arrangement.

• Requirement for internet connection supported through cable broadband or fiber optic service.