Senior Reconciliation Representative

Job Summary

Reconciliation of complex claims for payment, the full-time Senior Reconciliation Representative will work remotely to manage and resolve claims discrepancies while ensuring compliance with organizational policies.

Key responsibilities

• Reconciles and researches 2-step claims and payments from Health Plan Payors
• Communicates with Health Plans to check claim statuses and requests reprocessing of denied claims
• Documents findings and trends related to claims and maintains confidentiality of all claims documents

Required qualifications

• High School Diploma or GED certificate required
• 2 years of experience in claims processing preferred
• Familiarity with Managed Care, HMO, and PPO health plan provisions
• Basic knowledge of Microsoft Word and Excel
• Excellent interpersonal communication skills