Reconciliation Officer
2 weeks ago
JOB SUMMARY
The Reconciliation Officer ensures accurate and timely reconciliation of hospital and clinic bills, coordinating with Claims and Finance to resolve discrepancies and maintain smooth provider relationships.
JOB DUTIES AND RESPONSIBILITIES:
Coordinate efficiently with the Claims and Finance Departments regarding pertinent bills.
Manage, evaluate, and resolve reconciliation concerns accurately and within deadlines to ensure clarity of paid bills and avoid provider suspensions.
Reconcile bills promptly for claims processing within the assigned report period and turnaround time.
Build rapport and maintain good working relationships with provider counterparts.
Escalate reconciliation issues beyond authority to the supervisor or manager promptly and appropriately.
Ensure reconciliation processes deliver intended outcomes.
Provide feedback to immediate superior on opportunities for improvement and process innovations.
Promote a strong focus on customer service in all reconciliation activities.
Safeguard data integrity in all billing and reconciliation records.
Perform other duties as may be assigned from time to time.
JOB QUALIFICATIONS:
· College graduate
· Minimum of 1–2 years of experience in reconciliation, billing, claims processing, or finance-related work.
· Experience in healthcare, HMO, hospital, or clinic operations is an advantage.
· Background in provider relations or coordination with external partners preferred.
· Exposure to claims management and understanding of medical or hospital billing is a plus
· Knowledgeable in MS word and Excel, Google sheets.
SKILLS:
· Analytical skills – ability to review, evaluate, and reconcile bills and documents accurately.
· Attention to detail – ensures accuracy in billing reconciliation to prevent provider suspensions.
· Time management skills – ability to work under deadlines and meet turn-around times.
· Communication skills – strong verbal and written communication to coordinate with Claims, Finance, and Providers.
· Problem-solving and critical thinking – evaluates reconciliation issues and escalates appropriately.
· Data management skills – ability to handle and maintain accurate billing and reconciliation records.
· Interpersonal skills – builds rapport and maintains professional relationships with providers and colleagues.
· Customer service orientation – ensures processes remain provider and member-focused.
· Adaptability and flexibility – able to handle additional tasks or changes in process requirements.
· Technical proficiency – Google Sheets, MS Office (Excel, Word) and familiarity with billing systems or healthcare software.
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