Claims Processing Specialist, CA Candidate Only

Would you like to work for a software solutions company that has grown in triple digits in the last 5 years? If you answered Yes, then we need to talk....

We are looking for an Claims Processing Specialist who be part of a close-knit, high performing team. We are committed to creating an environment where all employees are valued and respected. This position offers a very competitive compensation and benefits package

Job Title :: Claims Processing Specialist

Job Location :: CA (100% Remote)

Position Description ::

Detailed Description:

• Processes related claims. Processes special claims payments specifically accident benefits and orthodontic. Processes foreign claims by translating and determining price. Processes returned clients checks, personal checks, undeliverable checks, stale dated checks, and requests for voids/stop-payments/re-issues. Determines refund amounts, defines AR amounts, and changes status of outstanding overpayments. Coordinates with accounting on special issues. Reviews and handles special professional reviews and services issues, and coordinates judgment with dentist consultants.
• Other duties include: processing special claims including manual check pricing, orthodontic and accident databases and reconciliation, as well as translating, deciphering, and adjudicating foreign claims. Performs miscellaneous duties as assigned.

Skills/Experience:

Job Requirements:

• A high school diploma or GED is preferred, but candidates with proven experience will not be excluded from consideration.
• A minimum of 2 years' experience in a office.
• Strong analytical, organizational and multi-tasking skills.
• Excellent customer service skills with ability to evaluate and respond to the contact needs.
• Ability to independently prioritize work and establish, understand and follow work rules and procedures, and take action to improve existing processes.
• Ability to confront difficult situations and make appropriate and timely decisions.
• Basic knowledge of accounting principles.
• Knowledge of Enterprise polices procedures and guidelines.
• PC literacy; MSOffice skills (Outlook, Word, Excel).
• Ability to work standard office equipment (personal computer, photocopy machine, fax machine, etc.).
• Ability to work expanded business hours including early morning, late evening and weekends
• Ability to work at a computer up to 7 hours a day.
• Ability to sit or stand 7.5 hours per day.
• Regularly required to sit for long periods of time, and occasionally stand and walk.
• Ability to hear voice communications.
• Close visual acuity required to read information on computer screens and written documents.
• Ability to maintain consistent, regular attendance. Ability to report to perform tasks in a physical work environment.
• Ability to clearly present written information and findings to all levels.
• Ability to communicate in a clear and concise manner.
• Ability to speak and understand English clearly to communicate with external/internal customers.
• Ability to interact well with employees and outside contacts.

About AgreeYa: AgreeYa is a global systems integrator delivering a competitive advantage for its customers through software, solutions, and services. Established in 1999, AgreeYa is headquartered in Folsom, California, with a global footprint and a team of more than 1,800+ professionals across offices. AgreeYa works with 550+ organizations ranging from Fortune 100 firms to small and large businesses across industries such as Telecom, Banking, Financial Services & Insurance, Healthcare, Utility & Energy, Technology, Public Sector, Pharma & Biotech, Retail, CPG, and others. Please visit us at www.agreeya.com for more information.

Job Type: Contract

Salary: Up to $28.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Claims /billing: 4 years (Required)
• Processing refunds, returned checks, overpayments: 4 years (Required)
• Medi-cal/Denti-Cal OR Medical: 4 years (Required)

Work Location: Remote