Help keep healthcare payments accurate behind the scenes from the comfort of home. If you like digging into details, solving payment discrepancies, and working independently on a focused workload, this remote reconciliation role might fit you perfectly.
About American Specialty Health
American Specialty Health (ASH) partners with health plans, employers, and members to promote healthier, longer lives through specialty health and fitness programs. They support large national networks using data, technology, and strong operations. As a Sr Reconciliation Representative, you’ll support that mission by making sure claims are reconciled and paid correctly.
Schedule
- Full-time, remote role within the United States
- Work-from-home with company-provided equipment
- Must have a designated, quiet home workspace
- Reliable high-speed internet required (minimum 50 Mbps download / 50 Mbps upload)
- Standard weekday schedule; must be available for virtual meetings and trainings as needed
What You’ll Do
- Reconcile 2-step claims and payments from health plan payors according to Explanations of Benefits (EOBs)
- Manually reconcile claims from paper EOBs and spreadsheets
- Contact health plans to check claim status, resolve underpayments, and request reprocessing of claims denied in error
- Use health plan and TPA websites to verify claim status and reconcile outstanding items
- Work aged, unreconciled, rejected, and 14-day reports to clear open claims
- Document detailed notes in internal systems (IHIS) and any assigned spreadsheets
- Flag and report trends in invalid denials from TPAs or health plans to leadership
- Meet department production and quality standards consistently
- Maintain strict confidentiality of all claims and member-related information
- Participate in required team meetings and trainings and support claims teammates as needed
What You Need
- High school diploma or GED required
- 2+ years’ experience with claims processing, reconciliation, or related healthcare billing preferred
- Basic computer, typing, and 10-key skills
- Knowledge of Microsoft Word and Excel
- Familiarity with managed care concepts (HMO, PPO, TPA provisions) is helpful
- Strong listening and interpersonal communication skills
- Ability to organize, prioritize, and manage multiple tasks in a changing environment
- Comfortable working independently in a remote setting with frequent interruptions
- Solid problem-solving skills and accuracy in reviewing numbers and documentation
- Ability to maintain strict confidentiality in all work
Benefits
- Pay: $17/hour (remote, WFH role)
- Company-provided technology and remote training
- Comprehensive benefits package (may include health, dental, vision, retirement, paid time off, and more, per company policy)
- Stable, operations-focused role with clear productivity and quality expectations
This one is a solid fit if you like quiet, focused work that still has a direct impact on getting claims paid correctly. Don’t overthink it. If the claims/healthcare world is familiar or interesting to you, move on it.
Happy Hunting,
~Two Chicks…