American Specialty Health · 10 hours ago
Sr Reconciliation Representative (Remote - $17/hr)
United States
Full-time
Remote
Mid, Senior Level
$17/hr - $17/hr
2+ years expAmerican Specialty Health is seeking a Sr Reconciliation Representative to join their Reconciliation department. The primary function of this position is to reconcile claims, including complex claims, for payment as per Explanation of Benefits from Health Plan Payors for 2-step accounts.
Health CareMedical
Responsibilities
Reconciles, resolves, and researches 2-step claims and payments to ASH
Manually reconciles claims for payment from Health Plan Payors received by paper EOBs or spreadsheets
Makes calls to Health Plans to check status of claims which may include payment or underpayment. In addition will request claims to be reprocessed if denied in error
Uses Health Plan and TPA websites to check on claim status or reconcile claims
Reconciles claims from various reports including but not limited to 14 day reports, aged reports, unreconciled reports, and rejected reports
Notifies supervisors of trends related to invalid denials by TPAs or Health Plans
Documents comments in internal notes fields in IHIS in addition to spreadsheets being worked
Reviews and responds to ASHCore logs within 48 hours of assigned date
Meets department production and quality requirements
Maintains confidentiality of all claims documents, records, and claims related issues
Promotes a spirit of cooperation and understanding among all personnel
Attends organizational meetings and trainings as required
Attends department meetings
Adheres to organizational policies and procedures
Recognizes unique and/or problem situations within area of assigned responsibility. Researches and makes recommendations to Supervisor
Provides assistance and teamwork to Claims Department staff in accomplishment of routine duties and special projects
Performs other duties as assigned
Complies with all policies and standards
Qualification
Required
High School Diploma or GED certificate required
2 years with claims processing, computer, typing, 10 key and telephone skills preferred
Knowledge of Microsoft Word and Excel helpful
Familiarity with Managed Care, HMO, PPO health plan provisions
Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment
Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships
Ability to display excellent customer service to meet the needs and expectations of both internal and external customers
Ability to effectively organize, prioritize, multi-task and manage time
Demonstrated accuracy and productivity in a changing environment with constant interruptions
Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions
Ability to exercise strict confidentiality in all matters
Ability to see, speak, and hear other personnel and/or objects
Ability to communicate both in verbal and written form
Ability to travel within and around the facility or Work from Home (WFH) environment
Capable of using a telephone, computer keyboard, and mouse
Ability to lift up to 10 lbs
Preferred
2 years with claims processing, computer, typing, 10 key and telephone skills preferred
Knowledge of Microsoft Word and Excel helpful
Familiarity with Managed Care, HMO, PPO health plan provisions
Company
American Specialty Health
American Specialty Health Incorporated (ASH) is one of the nation’s premier independent and privately-owned specialty health organizations offering technology-enabled services for benefits management, including clinical programs for musculoskeletal health, fitness programs, and well-being solutions for health plans, employers, associations, and others.
1001-5000 employees
Funding
Current Stage
Late StageTotal Funding
unknown2000-01-01Private Equity
Leadership Team
Troy Sechrist
Vice President, Strategic Partnerships
Douglas Metz
EVP & Chief Health Services Officer
Recent News
2025-11-04
Company data provided by crunchbase