Claims Associate Representative - EviCore
Core
Review, investigate, and resolve unpaid, denied, delayed, or underpaid medical claims to ensure accurate and timely reimbursement.
Role type
Claims Associate Representative (Accounts Receivable)
Builds
Accurate medical claim resolutions and timely payments to healthcare providers and third-party payers
Domain
Healthcare / Medical Billing / Accounts Receivable
Required skills
Medical claims processing, Accounts receivable operations, Account reconciliation, Financial analysis, Explanation of Benefits (EOB) interpretation, Explanation of Payment (EOP) interpretation, Microsoft Office (Word, Outlook, Excel), Analytical problem-solving, Attention to detail, Documentation management, Time management
Preferred skills
Account reconciliation and financial analysis experience
Technologies
Microsoft Office (Word, Outlook, Excel)
Responsibilities
Review and process accounts receivable claims within deadlines, Investigate denied/delayed/underpaid claims to identify root causes, Implement corrective actions to resolve claim balances, Conduct outbound calls to payers and providers to resolve issues, Maintain accurate documentation of claim activities, Monitor claim statuses and perform timely follow-ups, Escalate complex claims to senior representatives
Seniority
Entry-level to Mid-level, hands-on IC