Sr Reconciliation Representative (Healthcare)

TL;DR

Sr Reconciliation Representative (Healthcare): Reconciling claims and payments from Health Plan Payors with an accent on complex claim resolution and payment accuracy. Focus on manual reconciliation, interacting with Health Plans to resolve underpayments, and maintaining detailed documentation.

Location: Remote (Must be based in the United States)

Salary: $17/hr

Company

hirify.global provides specialized health services and claims management.

What you will do

• Reconcile, resolve, and research 2-step claims and payments from Health Plan Payors.
• Manually process claims based on paper EOBs or spreadsheets.
• Communicate with Health Plans to check claim status and request reprocessing for denied claims.
• Utilize TPA websites and various internal reports to manage aged and rejected claims.
• Document claim status and comments in internal systems and spreadsheets.
• Maintain strict confidentiality of all claims documents, records, and related issues.

Requirements

• High School Diploma or GED certificate.
• Must be based in the United States.
• 2 years of experience in claims processing, computer, typing, and telephone skills preferred.
• Proficiency in Microsoft Word and Excel.
• Familiarity with Managed Care, HMO, and PPO health plan provisions.
• Stable internet connection (minimum 50 down/10 up Mbps).

Culture & Benefits

• Full remote work-from-home (WFH) environment.
• Company-provided technology equipment.
• Equal Opportunity and Affirmative Action employer.
• Collaborative spirit of cooperation among personnel.