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Claims Associate Representatives

Company: Integrated Resources, Inc
Location: Franklin
Posted on: January 27, 2023

Job Description:

Client: CIGNA
Start: 01/09/2023
End: 06/30/2023

Reason: Special Project
Department: 4310-000 - CLAIMS ADMIN
Job Category: Customer Advocacy
Job Title: Claims Associate Representative
Duties: Delivers basic technical, administrative, or operative Claims tasks. Examines and processes paper claims and/or electronic claims. Completes data entry, maintains files, and provides support. Understands simple instructions and procedures. Performs Claims duties under direct instruction and close supervision. Work is allocated on a day-to-day or task-by-task basis with clear instructions. Entry point into professional roles.

Remote Work from Home, United States the Accounts Receivable Processor will be responsible for all facets of accounts receivable to ensure a complete review of outstanding accounts receivable with a strong concentration in revenue cycle management. Training will be onsite, worker must be in the Franklin, TN area or be willing to travel for initial training. The Accounts Receivable claim examiner must have a thorough knowledge of government, commercial, and other types of insurance billing guidelines in multiple states to demonstrate effective judgment when processing all claims with outstanding balances. Other responsibilities include:

Research/rectify third party denials/edits, requests for information and other related correspondence Process a variety of Third Party Administrator (TPA) payments Willingness to learn different claim platforms within eviCore and also client claims platforms when necessary Analyzes and clears payment variances Verify patients' eligibility, coverage, and benefits and identify authorization requirements relates to working aged AR.
Follow-up on outstanding account balances at 30-days from the date of service in accordance with client and organizational protocol with an emphasis on maximizing client satisfaction and provider profitability.
Process timely premium payments to providers Research and answer accounts receivable discrepancies Monitors payer responses, and other software as necessary to ensure prompt payment

Candidate must have an in-depth knowledge accounts receivable and related functions Proficient in Microsoft Office Products (Word, Outlook, Excel)
2-4 years claims handling and accounts receivable experience Can work both independently and collaboratively with a team Highly oriented to detail, planning and organizing skills Ability to work in a fast paced environment Time management and documentation skills Ability to perform basic mathematics calculations Exceptional reconciliation, analytic skills, and the ability to interpret EOBs/EOPs A high level of accuracy and attention to detail and have a dedicated approach to work

Education: .

High school Diploma or GED
2 year minimum experience in medical billing and/or claims accounts receivable

Skills and Experience:
Required Skills:
Additional Skills:

# of Positions: 15

Keywords: Integrated Resources, Inc, Franklin , Claims Associate Representatives, Other , Franklin, Tennessee

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