Fitness Reimbursement Examiner I (Remote)

Claims United States


Description

American Specialty Health Incorporated is seeking a Fitness Reimbursement Examiner to join our Fitness Reimbursement department. The primary purpose of this position is to enter data from fitness and exercise center billing reports into the Reimbursement Processing System.  This position is responsible for the accurate review, input and adjudication of reimbursement requests in accordance with regulations, ASH standards and contractual obligations of the organization.

Remote Worker Considerations:

Candidates who are selected for this position will be trained remotely and must be able to work from home in a designated work area with company-provided technology equipment.  

Responsibilities

  • Processes reimbursement requests accurately and efficiently.
  • Reviews all incoming reimbursement requests to verify necessary information.
  • Enters reimbursement requests and information into a computerized request Processing System.
  • Maintains all required documentation of reimbursement requests processed and reimbursement requests on hand.
  • Adjudicates reimbursement requests in accordance with departmental policies, procedures, state and accreditation standards and other applicable rules.
  • Maintains minimum production standard, 98.5%.
  • Provides backup for other examiners within the department.
  • Promotes a spirit of cooperation and understanding among all personnel.
  • Attends organizational meetings as required.
  • Adheres to organizational policies and procedures.
  • Maintains confidentiality of all files, reimbursement request reports, and reimbursement request related issues.

Qualifications

  • High school diploma required.
  • 10 key and word processing; minimum 10,000 key strokes per hour required with 95% accuracy. 
  • Data Entry Experience.
  • Proficient in MS Office.
  • Ability to recognize unique and/or problem situations and brings to attention of Supervisor.
  • Demonstrated ability to meet department performance standards and quality improvement processes.

Core Competencies

  • Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
  • Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
  • Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
  • Ability to effectively organize, prioritize, multi-task and manage time.
  • Demonstrated accuracy and productivity in a changing environment with constant interruptions.
  • Demonstrated ability to analyze information, problems, issues, situations and procedures to develop effective solutions.
  • Ability to exercise strict confidentiality in all matters.

Mobility

Primarily sedentary, able to sit for long periods of time. 

Physical Requirements

Ability to speak, see and hear other personnel and/or objects.  Ability to communicate both in verbal and written form. Ability to travel within the facility. Capable of using a telephone and computer keyboard.  Ability to lift up to 10 lbs.

Environmental Conditions

Work-from-home (WFH) environment.

This job posting is not applicable in CO.

American Specialty Health is an Equal Opportunity/Affirmative Action Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law. 

Please view Equal Employment Opportunity Posters provided by OFCCP here.

If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact our Human Resources Department at (800) 848-3555 x6702.

ASH will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company’s legal duty to furnish information.