Claims Processing Administrator (Check Runs)

About Us

All Care To You is a Management Service Organization providing our clients with healthcare administrative support. We provide services to Independent Physician Associations, TPAs, and Fiscal Intermediary clients. ACTY is a modern growing company which encourages diverse perspectives. We celebrate curiosity, initiative, drive and a passion for making a difference. We support a culture focused on teamwork, support, and inclusion. Our company is fully remote and offers a flexible work environment as well as schedules. ACTY offers 100% employer paid medical, vision, dental, and life coverage for our employees. We also offer paid holiday, sick time, and vacation time as well as a 401k plan. Additional employee paid coverage options available.

Job purpose

The Claims Processing Administrator ensures the efficient and accurate handling of claims-related financial transactions and documentation. This role is responsible for preparing and reconciling checks and Explanation of Benefits (EOBs), managing the mailing process, and logging transactions to maintain financial accuracy. The Coordinator will also support the Claims Department by participating in workflow projects, addressing error reports, and assisting with audits and other departmental needs.

Duties and responsibilities
? Prepare Claims Examiner?s reports in order to run checks.
? Accurately count the number of checks needed by IPA/Hospital.
? Log the number of checks requested by IPA/Hospital.
? Run checks and EOBs
? Reconcile checks and EOBs in order to scan for Finance and Claims.
? Log checks in order to follow up with IPAs that exceed more than 7 days of not returned from signature.
? Prepare checks for mailing once completed with signatures.
? Mailing of checks and EOBs within 48 hours of receipt.
? Charge the correct client account for postage of mail outs from the Claims Dept.
? Identify and notify Management of ongoing issues with the error reports in order to minimize the number of errors on future inloads.
? Participate in claims workflow projects.
? Complies with all Company and Department Policies and Procedures.
? When needed assist in claims audit activities.
? Support the Claims Department as business needs require.
? May have customer/client contact.
? Support other departments as needed.
? All other duties as assigned.

Qualifications
? 2+ years or more experience in a managed care environment.
? Familiar with all regulatory requirements including CMS, DMHC and DHS.
? Proficient with all Federal and state requirements in claim processing.
? Excellent communication skills including reports, correspondence, and verbal communications.
? EzCap experience preferred.

?Proficiency using Outlook, Microsoft Teams, Zoom, Microsoft Office (including Word and Excel) and Adobe

?Detail oriented and highly organized

?Strong ability to multi-task, project management, and work in a fast-paced environment

?Strong ability in problem-solving

?Ability to self-manage, strong time management skills

?Ability to work in an extremely confidential environment

?Strong written and verbal communication skills

Working conditions:
? This job may require flexible work hours due to the nature of the responsibilities.

Physical requirements

?Sitting/standing for extended periods of time.

Salary Range:

$18.00 - $25.00

Job Type: Full-time

Pay: $18.00 - $25.00 per hour

Benefits:
? 401(k) matching
? Dental insurance
? Employee assistance program
? Health insurance
? Life insurance
? Paid time off
? Vision insurance
? Work from home

Schedule:
? 8 hour shift
? Monday to Friday

Experience:
? Managed care: 2 years (Preferred)

Work Location: Remote