Account Administration Representative

Account Administration Representative

Apex Systems is hiring for an Account Administration Representative for a major healthcare client!

Location : San Diego, CA (Partial Remote) Must live within 2-hours of Mission Valley. 6 months contact with potential to extend. You must be able to work within the United States without sponsorship.

Purpose : This position supports the Membership / Contracts functions within a centralized service center. The primary responsibilities include account maintenance, billing, reconciliation, reporting, and customer service. Additional duties involve database maintenance, research, contract and ID card generation, facilities support, and document imaging. This role will be involved with reviewing and resolving member NON-clinical grievances.

Key Responsibilities :

• Reconcile billing payments to ensure accurate eligibility, payment, revenue, and membership records.
• Process and maintain member data, including enrollments, corrections, retroactive adjustments, and terminations.
• Respond to eligibility inquiries and ensure timely and accurate billing.
• Communicate with benefit administrators to explain policies and resolve membership and billing issues.
• Support sales and service representatives in resolving membership accounting problems.
• Conduct audits for purchasers with payment variances or delinquencies and resolve discrepancies.
• Ensure compliance with policies and contractual provisions.
• Prepare reports and manage purchaser correspondence.
• Process daily purchaser deposits and bank sources accurately and on time.
• Assist in producing and distributing payment-related reports and maintaining related equipment.
• Support Medicare processing and reporting requirements.
• Update contract systems with changes quickly and accurately.
• Produce and distribute contracts and notices for new and renewing purchasers.
• Manage medical record number (MRN) issues and follow up as needed.
• Coordinate electronic eligibility reporting and maintain related equipment and logs.
• Identify, code, batch, scan, and index documents for imaging.
• Provide office services support, including mail handling, filing, supply management, and copier maintenance.
• Collaborate with internal and external stakeholders to resolve support service issues.
• Track productivity and customer service quality metrics.
• Participate in team projects and contribute to service and operational improvements.
• Assist with training and facilitate cross-functional communication.
• Contribute to performance evaluations and target-setting activities.
• Perform other duties as assigned.

Requirements :

Required Technologies : Microsoft 360

Experience in below is a plus : EPIC Oracle

EEO Employer

Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law.