Claims Associate Representatives
Company: Integrated Resources, Inc
Location: Franklin
Posted on: January 27, 2023
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Job Description:
Client: CIGNA
Start: 01/09/2023
End: 06/30/2023
Description:
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
Skills:
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
Keywords:
Education: .
High school Diploma or GED
2 year minimum experience in medical billing and/or claims accounts
receivable
Skills and Experience:
Required Skills:
ADJUDICATING
Additional Skills:
MATHEMATICS
ACCOUNTING
CLAIMS PAYMENTS
BENEFITS
ACCOUNT RECEIVABLE
# of Positions: 15
Keywords: Integrated Resources, Inc, Franklin , Claims Associate Representatives, Other , Franklin, Tennessee
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