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The Accounts Payable Associate (Claims Adjudication Associate) facilitates proactive positive relationships with providers. Placing emphasis on resolution of issues that prevent accurate payment of provider invoices, while ensuring provider expenses are matched with carrier revenues.
Job Responsibility:
Review system documents to ensure accurate and timely processing of provider invoices for payment
Attention to detail with the ability to review and analyze invoices, Single Rate Agreement’s, contracts and documents to appropriately process payments
Work with operations team to correct purchase orders (PO’s) and align them with authorizations from carriers, and services rendered and billed by the provider
Work with the network to ensure problems are resolved quickly and efficiently
Research and communicate via email and/or telephone with providers on additional items required to process invoices for payments (Notes, corrected invoice, Purchase Order)
Research and resolve short payments and communicate findings to provider while processing additional payments when justified
Resolve inquiries and escalations from assigned providers
Proper review of billings to carrier to avoid potential revenue impacts
Build and maintain a partnership with the providers
Initiate and or facilitate calls with the providers
Provider Satisfaction
Perform detailed reviews/audits of all documentation supporting payments for appeals in accordance with Company policies and procedures
Ensure that invoices and other payment requests are data-entered into system under the appropriate “payor” entity
Work with Procurement/Sourcing buyers to resolve authorization related issues
Troubleshoot customer problems, identifies the root cause of the problem
Participate in and support process improvement and system enhancement projects
A strong ability to analyze documents, invoices, contracts in regard to payments
Tracks and documents inbound requests and ensures proper notation of problems or issues
Enforce Accounts Payable Customer Support processes and protocols
Other duties as assigned
Requirements:
High school diploma or General Educational Development (G.E.D.)
Microsoft Word, Excel, Outlook skills required – Must Pass Intermediate Excel Test
Excellent oral and written communication skills required
Must be detail oriented and have the ability to multi-task
Must be able to follow instructions, prioritize and meet deadlines
Must have strong problem solving and critical thinking skills
Must have excellent research skills
Ability to work in an environment that aligns with the company's diversity, equity, inclusion and belonging standards
Ability to work both independently and in a team environment
Demonstrate our core values of Think Big, Go Fast, Deliver Awe, and Win Together
Nice to have:
Experience using medical claims software systems a plus
Experience with medical accounting or insurance a plus
What we offer:
Remote Work: We are a remote-first company
Generous Time Off: Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off
Comprehensive Benefits Package: Including medical, dental, vision, and pet insurance
401(k) matching program
and company-paid life insurance and short and long-term disability coverage
Supportive Services: Colleague Assistance Program that provides free counseling and financial services
One Call Foundation provides colleagues financial assistance during times of unexpected hardships