Talent.com
Sr Reconciliation Representative (Remote - $17/hr)
Sr Reconciliation Representative (Remote - $17/hr)American Specialty Health Incorporated • San Diego, CA, United States
Sr Reconciliation Representative (Remote - $17 / hr)

Sr Reconciliation Representative (Remote - $17 / hr)

American Specialty Health Incorporated • San Diego, CA, United States
3 days ago
Job type
  • Full-time
Job description

Description

American Specialty Health Incorporated (ASH) is seeking an Sr Reconciliation Representative to join our Reconciliation department.

The primary function of this position is to reconcile claims, including complex claims, for payment as per Explanation of Benefits from Health Plan Payors for 2-step accounts.

Remote Worker Guidelines

  • Remote Worker Guidelines : This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network (minimum 50 Mbps download and 50 Mbps upload speed.)

Responsibilities

  • Reconciles, resolves, and researches 2-step claims and payments to ASH.
  • Manually reconciles claims for payment from Health Plan Payors received by paper EOBs or spreadsheets.

  • Makes calls to Health Plans to check status of claims which may include payment or underpayment. In addition will request claims to be reprocessed if denied in error.
  • Uses Health Plan and TPA websites to check on claim status or reconcile claims.
  • Reconciles claims from various reports including but not limited to 14 day reports, aged reports, unreconciled reports, and rejected reports.
  • Notifies supervisors of trends related to invalid denials by TPAs or Health Plans.
  • Documents comments in internal notes fields in IHIS in addition to spreadsheets being worked.
  • Reviews and responds to ASHCore logs within 48 hours of assigned date.
  • Meets department production and quality requirements.
  • Maintains confidentiality of all claims documents, records, and claims related issues.
  • Promotes a spirit of cooperation and understanding among all personnel.
  • Attends organizational meetings and trainings as required.
  • Attends department meetings.
  • Adheres to organizational policies and procedures.
  • Recognizes unique and / or problem situations within area of assigned responsibility. Researches and makes recommendations to Supervisor.
  • Provides assistance and teamwork to Claims Department staff in accomplishment of routine duties and special projects.
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • Qualifications

  • High School Diploma or GED certificate required.
  • 2 years with claims processing, computer, typing, 10 key and telephone skills preferred.
  • Knowledge of Microsoft Word and Excel helpful.
  • Familiarity with Managed Care, HMO, PPO health plan provisions.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.
  • Mobility

  • Primarily sedentary, able to sit for long periods of time.
  • Physical Requirements

  • Ability to see, speak, and hear other personnel and / or objects. Ability to communicate both in verbal and written form. Ability to travel within and around the facility or Work from Home (WFH) environment. Capable of using a telephone, computer keyboard, and mouse. Ability to lift up to 10 lbs.
  • Environmental Conditions

  • Work-from-home (WFH) environment.
  • American Specialty Health is an Equal Opportunity / Affirmative Action Employer.

    All qualified applicants will receive consideration for employment without regard to sex (including pregnancy, childbirth, related medical conditions, breastfeeding, and reproductive health decision-making), gender, gender identity, gender expression, race, color, religion (including religious dress and grooming practices), creed, national origin, citizenship, ancestry, physical or mental disability, legally-protected medical condition, marital status, age, sexual orientation, genetic information, military or veteran status, political affiliation, or any other basis protected by applicable local, federal or state law.

    Please view Equal Employment Opportunity Posters provided by OFCCP here .

    If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

    ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.

    Create a job alert for this search

    Representative Remote • San Diego, CA, United States

    Related jobs
    Sr. Employee Relations Partner

    Sr. Employee Relations Partner

    Outback Steakhouse • San Diego, CA, United States
    Full-time
    We’re seeking a second Senior HR Partner to join our high-performing HR team and help lead our people strategy across 74 restaurant locations in five states. This is more than an HR role; it’s a lea...Show more
    Last updated: 30+ days ago • Promoted
    Community Relations Representative ($21.35 - $25.43)

    Community Relations Representative ($21.35 - $25.43)

    Irvine • San Diego, CA, US
    Full-time
    Community Relations Representative.Assists the Community Manager and Assistant Manager with on-site operations of a single community, multiple communities, or neighborhood ("operating unit").Serves...Show more
    Last updated: 30+ days ago • Promoted
    Account Administration Representative

    Account Administration Representative

    National Association of Latino Healthcare Executives • San Diego, CA, United States
    Full-time
    To work as a team member of the California Service Center (CSC) which is the Membership Accounting and Contracts Administration functions for the California Division. The overall objectives of this ...Show more
    Last updated: 3 hours ago • Promoted • New!
    Remote Customer Service Associate

    Remote Customer Service Associate

    TradeJobsWorkforce • 92198 San Diego, CA, US
    Remote
    Full-time
    As a Remote Customer Service Associate, you will be responsible for supporting customers and handling inquiries from the comfort of your home, including : respond to customer inquiries via phone, ch...Show more
    Last updated: 30+ days ago • Promoted
    Integration Specialist, Strategic Integration

    Integration Specialist, Strategic Integration

    Jewish Family Service • San Diego, CA, United States
    Full-time
    Jewish Family Service of San Diego.Manager, Strategic Integration.In addition to standard pay, compensation for this position includes : . Comprehensive, low-cost healthcare coverage for employees.Gen...Show more
    Last updated: 18 days ago • Promoted
    Manager, Partnership Growth - US Based Remote

    Manager, Partnership Growth - US Based Remote

    San Diego Staffing • San Diego, CA, US
    Remote
    Full-time
    Anywhere Leads is a lead generation group within the Anywhere organization.The Anywhere Leads Network is home to some of the most well-known brands in the nation, including over 500 brokers across ...Show more
    Last updated: 23 days ago • Promoted
    Temporary Hurricane Contact Center Representative

    Temporary Hurricane Contact Center Representative

    MCI • San Diego, CA, US
    Full-time
    MCI is a leading Business Process Outsourcing (BPO) company that specializes in delivering tailored solutions to meet the diverse needs of our clients. With a commitment to excellence and a focus on...Show more
    Last updated: 22 days ago • Promoted
    Client Success Representative (Remote, Contract)

    Client Success Representative (Remote, Contract)

    Infuse • San Diego, CA, US
    Remote
    Full-time
    Client Success Representative (Remote, Contract).We will review your application against our job requirements.We do not employ machine learning technologies during this phase as we believe every hu...Show more
    Last updated: 21 days ago • Promoted
    Managing Partner

    Managing Partner

    Care To Stay Home • San Diego, CA, United States
    Full-time
    Care To Stay Home (CTSH) is seeking a high‑performing.This entrepreneurial leadership role is ideal for individuals passionate about relationship‑building, operational excellence, and improving the...Show more
    Last updated: 30+ days ago • Promoted
    Corporate Counsel

    Corporate Counsel

    Scripps Health • San Diego, CA, United States
    Full-time
    Offering a hybrid work schedule with onsite requirement 2-3 times per week.Eligible to participate in the Director Incentive Plan and eligible for new hire incentives. Founded in 1924, Scripps Healt...Show more
    Last updated: 9 hours ago • Promoted • New!
    Director, Employee Relations

    Director, Employee Relations

    Intuit • San Diego, CA, US
    Full-time
    Employee Relations Team Leader.Our Employee Relations team at Intuit enables a psychologically safe and supportive work environment that allows employees to do the best work of their lives.We manag...Show more
    Last updated: 17 days ago • Promoted
    Associate Counsel

    Associate Counsel

    Alliant • San Diego, CA, United States
    Full-time
    Alliant Insurance is hiring an Associate Counsel for our P&C Division!.Under the supervision of the Assistant General Counsels, the Associate Counsel will be responsible for advising Alliant corpor...Show more
    Last updated: 9 hours ago • Promoted • New!
    Associate Director, Sales Compensation Design

    Associate Director, Sales Compensation Design

    Illumina • San Diego, CA, United States
    Full-time
    Associate Director, Sales Compensation Design.Diversity, equity, and inclusion are core principles at Illumina.We celebrate a culture that continuously creates an inclusive environment where employ...Show more
    Last updated: 15 hours ago • Promoted • New!
    Associate Director, Revenue Recognition – MedTech (ASC 606)

    Associate Director, Revenue Recognition – MedTech (ASC 606)

    BD • San Diego, CA, United States
    Full-time
    A global medical technology company seeks an Associate Director of Finance to manage revenue recognition for its Medication Management Solutions division. This role involves strategic financial guid...Show more
    Last updated: 3 hours ago • Promoted • New!
    Agriculture / Groundskeeping

    Agriculture / Groundskeeping

    The Orthodox Christian Mission Center • Rosarito, Baja California, Mexico
    Innocent Orphanage is situated on a 16-acre ranch which requires a great deal of landscaping and upkeep of the irrigation systems for the property. Individuals with knowledge of agriculture, who can...Show more
    Last updated: 19 days ago • Promoted
    Associate Counsel, California (Remote)

    Associate Counsel, California (Remote)

    Government Employees Insurance Company • San Diego, CA, United States
    Remote
    Full-time
    Associate Counsel, California (Remote) page is loaded.Associate Counsel, California (Remote).Apply remote type Remote locations San Diego, CA CA San Francisco - JPS Sacramento, CA CA Los Angeles - ...Show more
    Last updated: 30+ days ago • Promoted
    Lender Services Specialist - US Remote

    Lender Services Specialist - US Remote

    Remote Staffing • San Diego, CA, US
    Remote
    Permanent +1
    Lender Services Specialist - Remote.Our Title Group is a leading full-service title and settlement services company, serving real estate companies, corporations, and financial institutions in suppo...Show more
    Last updated: 20 hours ago • Promoted • New!
    Global TA Lead - Revenue and North America

    Global TA Lead - Revenue and North America

    ResMed Inc • San Diego, CA, United States
    Full-time
    Global TA Lead - Revenue and North America page is loaded## Global TA Lead - Revenue and North Americalocations : San Diego, CA, United States : CA Canada (ResMed Halifax - Remote)time type : Fu...Show more
    Last updated: 12 days ago • Promoted