Claims Reconciliation Agent
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Key skills for this role
About the Role
Nextcare seeks a Claims Reconciliation Agent to review and reconcile claims data, identify discrepancies, and support audits. The role requires a bachelor's degree in a related field and 2-3 years of experience in claims reconciliation or financial analysis.
Key Skills for This Role
Responsibilities
- Review and analyze claims to ensure they are accurate and complete
- Process claims adjustments and corrections as necessary
- Reconcile claims data with financial records and systems
- Identify and investigate discrepancies in claims transactions and ensure timely and accurate reconciliation
- Analyze claims data to identify trends and patterns
- Prepare reports and presentations on claims performance and reconciliation outcomes
- Assist in internal and external audits related to claims and reconciliation
- Maintain accurate and organized documentation for audit purposes
- Work closely with finance, processors, and customer service departments to resolve claims issues
- Communicate effectively with stakeholders to address and resolve claims discrepancies
- Handle direct communication with healthcare providers on rejection ratio and reconciliation review findings
- Conduct reconciliation meetings with stakeholders as required
Requirements
- Bachelor’s degree in Medical field, Finance, Business Administration, Insurance, or related field preferred
- Minimum of 2 3 years of experience in claims reconciliation, financial analysis, or similar role
- Experience in insurance or healthcare industry preferred
- Strong analytical and problem solving skills
- Proficiency in Microsoft Excel and other data analysis tools
- Excellent attention to detail and accuracy
- Strong organizational and time management skills
- Ability to work independently and as part of a team
- Excellent written and verbal communication skills
- Legally permitted to work in the country of operations
Full Job Posting
What You Do
- Review and analyze claims to ensure they are accurate and complete.
- Process claims adjustments and corrections as necessary.
- Reconcile claims data with financial records and systems.
- Identify and investigate discrepancies in claims transactions and ensure timely and accurate reconciliation of claims.
- Analyze claims data to identify trends and patterns.
- Prepare reports and presentations on claims performance and reconciliation outcomes.
- Utilize data analytics tools to improve the efficiency of the claims reconciliation process.
- Assist in internal and external audits related to claims and reconciliation.
- Maintain accurate and organized documentation for audit purposes.
- Work closely with the finance, processors, and customer service departments to resolve claims issues.
- Communicate effectively with stakeholders to address and resolve claims discrepancies.
- Handle and support direct communication with the healthcare providers on their rejection ratio and reconciliation review findings.
What You Bring
- Bachelor’s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
- Minimum of 2 3 years of experience in claims reconciliation, financial analysis, or a similar role.
- Experience in the insurance or healthcare industry is preferred.
- Strong analytical and problem solving skills.
- Proficiency in Microsoft Excel and other data analysis tools.
- Excellent attention to detail and accuracy.
- Strong organizational and time management skills.
- Ability to work independently and as part of a team.
- Excellent written and verbal communication skills.
- Familiarity with claims processing systems and software.
- Understanding of regulatory requirements related to claims and reconciliation.
- Knowledge of accounting principles and practices.
What We Offer
- Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance.
- Allianz Group is one of the most trusted insurance and asset management companies in the world.
- We welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation.
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