Bilingual Claims Processor

Location

Reno, NV | United States

Job description

Best Place to Work in Northern Nevada - 2nd Place three years in a row.
Best Place to Work for Working Parents - 2022.

Check out our AWESOME Benefits!

• 4 weeks Paid Time Off in the First Year - Front Loaded
• 14 paid holidays annually
• Hybrid Work Options Available
• 403B Retirement Plan with 4% Match
• 4 Weeks Paid Parental Leave
• Up to 4 Weeks Paid Extended Medical Leave
• Medical, Dental, and Vision benefits - effective 1st DAY OF THE MONTH, following date of hire
• Free Health Insurance Options for Full Time Employees
• Low-Cost Health Insurance Options for Dependents
• Health Reimbursement Account
• Employee Hardship Loan Program
• Free Life Insurance and Long-Term Disability
• Tuition Assistance
• Continuing Education Support
• Dog Friendly Workplace
• Infant Friendly Workplace
• Additional Perks and Discounts
• Great Organizational Culture!

The Ryan White Claims Processor is responsible for maintaining the highest professional and ethical standards in representing Access to Health Network (AHN) to Ryan White clients and business partners. The ideal candidate is a motivated, hard-working, organized individual who performs well under pressure and can multi-task. This position is responsible for assisting Ryan White clients with enrolling into an insurance product as well as processing premium and cost share payments for medical, dental, and/ or vision claims.

Key responsibilities and accountabilities:

• Must be able to obtain Exchange Enrollment Facilitator license through the state of nevada (license fees paid by AHN)
• Gain and maintain a general working knowledge of health insurance systems and terminology
• Gather information from AHN Ryan White clients to determine payer of last resort.
• Accurately and efficiently record all pertinent client information into CareWare and Salesforce
• Perform detailed, accurate review of all applications that may qualify for insurance
• Treat AHN clients and prospective clients with respect and dignity at all times
• Process insurance payments
• Help eligible consumers enroll in Premium Assistance Program which is also known as 3rd Party Reimbursement.
• Process premium payments on behalf of consumers for state approved insurance plans
• Process medical, dental, and/ or vision payments on behalf of consumers for copays/ deductible.
• Eligibility screening for potential Ryan White Part B applicants to ensure clients are eligible for assistance
• Maintain and process HIP and SPAP monthly premium payments.
• Make sure that the Ryan White Part B files are up to date with the necessary documents
• Fulfill parts of the Scope of Work for the Nevada Department of Health and Human Services sub grant

Other requirements :

• Gain a general working knowledge of Nevada/Federal Health Exchange, HIP, Access to Healthcare Network, State Health Insurance Subsidies/Assistance Program, and Medicaid including the eligibility criteria and enrollment process
• Implement critical thinking abilities with an emphasis on research skills and resourcefulness
• Ability to be both compassionate and professional while soliciting and serving our population
• Demonstrated experience in planning and execution of organization communication
• Ability to describe and communicate complex concepts
• Gain a clear and working knowledge of the Access Health Software system used in tracking demographics and service data, case management and member referral s
• Abide by HIPAA requirements
• Gain a clear and basic knowledge of Access to Healthcare Network Services
• Gain a basic and clear working knowledge of the Shortel phone system
• Gain a basic and clear working knowledge of Salesforce
• Ability to be both compassionate and professional while serving our population
• Ability to be both compassionate and professional with staff
• Must attend staff meetings and be willing to meet with manager on a consistent and regular basis
• Ability to adapt to changing work environment and duties
• Other duties as assigned

Qualifications

• Minimum Education: High School Diploma; AA Degree Preferred
• Minimum one-year health insurance, sales, health insurance specialist experience preferred.
• Excellent Communication Skills - oral, written and verbal
• Excellent customer service skills
• Minimum three years computer experience including Microsoft operating systems, word processing, spreadsheets, data base input and report generation
• Quick and accurate data entry skills
• Excellent organizational skills
• Be able to sit at a computer for up to 6 - 8 hours per day
• Be able to withstand hand/wrist deviation and repetition
• Must have a valid driver's license and be able to drive the AHN Company Car when needed
• Must be able to lift, carry up to 30 pounds with a fair consistency
• Flexibility; Each department selects the hours of work schedule for the department staff based on the department's needs. This schedule may change at any time according to the department's needs.
• Required to pass a background check through the State of Nevada

work environment

• The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office environment

*The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified. As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network. Furthermore, they do not establish a contract or implied contract for employment.

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds. We encourage all qualified candidates to apply.

Job tags

Salary

$24.03 per hour