Bilingual Claims Processor

Access To Healthcare Network

Reno, NV

Expired: April 21, 2024 Applications are no longer accepted.

Vision , Medical , Dental , Paid Time Off , Life Insurance , Retirement
Full-Time

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 referrals
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.