Reconciliation Representative

TL;DR

Reconciliation Representative: Reconciling and resolving complex claims for payment from Health Plan Payors with an accent on accuracy, data entry, and communication with health plans. Focus on managing 2-step accounts, processing EOBs, and ensuring compliance with internal quality standards.

Location: Must be based in San Diego, CA (Onsite)

Salary: $15.99–$17.00 per hour

Company

hirify.global is a healthcare organization focused on specialty health programs and claims management.

What you will do

• Reconcile and resolve 2-step claims and payments to the organization.
• Receive, sort, and scan incoming paper and electronic EOBs and health plan letters.
• Communicate with health plans to check claim status, resolve underpayments, and request reprocessing for denied claims.
• Maintain accurate records and documentation in internal systems and spreadsheets.
• Monitor and report trends related to invalid denials by TPAs or health plans.
• Meet department production and quality requirements while maintaining strict confidentiality.

Requirements

• High School Diploma or GED required.
• 2 years of experience in claims processing, data entry, and telephone support.
• Proficiency with computer systems, typing, and 10-key data entry.
• Familiarity with Managed Care, HMO, and PPO health plan provisions.
• Strong listening and interpersonal communication skills.
• Must be able to work full-time onsite in San Diego, CA.

Nice to have

• Knowledge of Microsoft Word and Excel.

Culture & Benefits

• Equal Opportunity and Affirmative Action employer.
• Professional office environment with a focus on teamwork and cooperation.
• Opportunities for training and organizational development.