What are the responsibilities and job description for the A/R Claims Specialist position at Careington International Corporation?
For more than 45 years, Careington International has been a leader in the health and wellness benefits space. Since its founding in 1979, Careington has been delivering dental discount solutions as its core competency. Today, Careington has expanded to offer a growing portfolio of 150 health, wellness, lifestyle and virtual health products and services designed to deliver cost savings across a spectrum of life needs. Through its affiliated nationally licensed third-party administrator (TPA), Careington International also delivers full-scale administrative services, including customer service, licensed enrollment, claims administration, individual and group billing.
Duties And Responsibilities
Qualifications, Experience, and Skills:
Duties And Responsibilities
- Submission of request for funds (RFFs) for clients based on schedule or delivery.
- Submission of client invoices.
- Work collaboratively with Finance for the reconciliation of the clients funding accounts.
- Provide low balance client account information to the Account Management team.
- Assist with voids, refunds, and recoupments from overpaid claims.
- Assist with the resolution of escalated, DOI, OIG, OIC, and BBB complaints and appeals.
- Process first submission claims requiring re-adjudication.
Qualifications, Experience, and Skills:
- Advanced computer skills and experience with MS Application – Adobe, Excel, Word, Outlook is required.
- Accounts Receivable experience.
- Minimum 2-year administrative office experience.
- Associate degree or equivalent combination of education and experience.
- Claims Processing Background.
