Claims Senior Representative

Immediate need for a talented Claims Senior Representative. This is a 12+ Months Contract  opportunity with long-term potential and is located in U.S.(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:25-60238

Pay Range: $17 - $18/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities: 

• Delivers specific delegated claims tasks assigned by a supervisor.
• Examines electronic claim denials to determine next action.
• Follows established departmental and/or corporate policies and procedures to resolve claims issues.
• Interacts with agents and/or patients by email and phone to correct claim form errors.
• Completes claim denials without direct supervision, seeks understanding of unfamiliar claims when necessary.
• Ability to multi-task in multiple systems.
• Basic knowledge of health insurance billing.
• Knowledgeable in assessing explanation of benefits (EOBs) from insurance companies (payer portals).
• Ability to process a high volume of claims corrections, 100+ claims per day
• The ability to identify and resolve payment posting issues.
• Consistently meets agreed-upon department metrics.
• The ability to identify an overpayment and determine when a refund is due (patients/insurance).
• The ability to research and resolve simple to complex issues and or escalate issues to management when necessary.

Key Requirements and Technology Experience:

• Skills-Claims, Athena, Availity and Medical Billing.
• Provided excellent customer service to patients and insurance companies.
• At least 1 year of experience in medical insurance billing.
• Ability to work independently and as part of a team.
• This position includes fiduciary duty or access to financial systems: Yes
• Recent experience (within 2 years) with Athena Health.
• Basic Excel skills.
• Past experience using payer websites such as Availity.

Our client is a leading Healthcare Insurance Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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