Embark on a rewarding career journey with All Care To You, a pioneering Management Service Organization dedicated to delivering exceptional healthcare administrative support. We’re seeking a highly skilled Claims Processing Administrator (Check Runs) to join our dynamic team, working remotely and enjoying a flexible schedule. As a valued member of our organization, you’ll receive a competitive salary and comprehensive benefits package, recognizing your expertise and commitment to excellence.
About Us: All Care To You is a forward-thinking company that fosters a culture of innovation, teamwork, and diversity. We provide top-notch services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients, celebrating curiosity, initiative, and passion for making a difference. Our fully remote work environment offers flexibility, 100% employer-paid medical, vision, dental, and life coverage, paid holidays, sick time, vacation time, and a 401k plan.
Job Purpose:
The Claims Processing Administrator plays a vital role in ensuring the efficient and accurate handling of claims-related financial transactions and documentation. This position is responsible for preparing and reconciling checks and Explanation of Benefits (EOBs), managing the mailing process, and logging transactions to maintain financial accuracy. The successful candidate will also support the Claims Department by participating in workflow projects, addressing error reports, and assisting with audits and other departmental needs.
Key Responsibilities:
- Prepare Claims Examiner’s reports to run checks, accurately counting and logging the number of checks needed by IPA/Hospital.
- Run checks and EOBs, reconciling them for Finance and Claims.
- Log checks to follow up with IPAs that exceed 7 days without return from signature.
- Prepare checks for mailing, ensuring timely delivery within 48 hours of receipt.
- Charge the correct client account for postage and identify ongoing issues with error reports to minimize future errors.
- Participate in claims workflow projects, comply with Company and Department Policies and Procedures, and assist in claims audit activities as needed.
- Provide support to the Claims Department, other departments, and clients as required.
Qualifications:
- 2+ years of experience in a managed care environment, with familiarity with regulatory requirements (CMS, DMHC, and DHS) and federal and state requirements in claim processing.
- Excellent communication skills, including reports, correspondence, and verbal communications.
- EzCap experience preferred, with proficiency in Outlook, Microsoft Teams, Zoom, Microsoft Office (Word and Excel), and Adobe.
- Detail-oriented, highly organized, and able to multi-task, manage projects, and work in a fast-paced environment.
- Strong problem-solving skills, ability to self-manage, and excellent time management skills.
- Ability to work in an extremely confidential environment and maintain strong written and verbal communication skills.
What We Offer:
- Competitive salary ($18.00 – $25.00 per hour)
- Comprehensive benefits package, including 401(k) matching, dental insurance, employee assistance program, health insurance, life insurance, paid time off, vision insurance, and work-from-home arrangements.
- Flexible schedule, with an 8-hour shift, Monday to Friday.
- Opportunities for growth and development in a dynamic and innovative company.
We Want to Hear From You!
If you’re a motivated and skilled professional looking for a new challenge, apply today and join our team of dedicated professionals. Together, let’s build a brighter future for healthcare administration.
