Sr Reconciliation Representative (Remote - $17/hr)

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<p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">American Specialty Health Incorporated (ASH) is seeking an Sr Reconciliation Representative to join our Reconciliation department.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Remote Worker Guidelines</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.)</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Responsibilities</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Reconciles, resolves, and researches 2-step claims and payments to ASH.</span><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Manually reconciles claims for payment from Health Plan Payors received by paper EOBs or spreadsheets.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Uses Health Plan and TPA websites to check on claim status or reconcile claims.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Reconciles claims from various reports including but not limited to 14 day reports, aged reports, unreconciled reports, and rejected reports.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Notifies supervisors of trends related to invalid denials by TPAs or Health Plans.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Documents comments in internal notes fields in IHIS in addition to spreadsheets being worked.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Reviews and responds to ASHCore logs within 48 hours of assigned date.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Meets department production and quality requirements.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Maintains confidentiality of all claims documents, records, and claims related issues.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Promotes a spirit of cooperation and understanding among all personnel.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Attends organizational meetings and trainings as required.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Attends department meetings.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Adheres to organizational policies and procedures.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Recognizes unique and/or problem situations within area of assigned responsibility. Researches and makes recommendations to Supervisor.</span></li></ul></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Provides assistance and teamwork to Claims Department staff in accomplishment of routine duties and special projects.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Performs other duties as assigned.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Complies with all policies and standards.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Qualifications</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">High School Diploma or GED certificate required.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">2 years with claims processing, computer, typing, 10 key and telephone skills preferred.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Knowledge of Microsoft Word and Excel helpful.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Familiarity with Managed Care, HMO, PPO health plan provisions.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Core Competencies</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to effectively organize, prioritize, multi-task and manage time.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated accuracy and productivity in a changing environment with constant interruptions.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.</span></li><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Ability to exercise strict confidentiality in all matters.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Mobility</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Primarily sedentary, able to sit for long periods of time.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Physical Requirements</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>Environmental Conditions</strong></span></p><ul><li style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Work-from-home (WFH) environment.</span></li></ul><p><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;"><strong>American Specialty Health is an Equal Opportunity/Affirmative Action Employer.</strong></span></p><p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">Please view Equal Employment Opportunity Posters provided by OFCCP <u><a href="http://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm">here</a></u>.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span><br><br><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">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.</span></p><p><span style="font-family: sans-serif , arial , helvetica;font-size: 10.0pt;">#LI-Remote #Recon #Healthcae #Claims #Examin</span></p>

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