Program & Claims Specialist in Asheville, North Carolina at Friday Services

Healthcare Program & Claims Support Representative

Location: Asheville, 28806
Pay Rate: $19.75
Schedule: 8:30am-5pm
Assignment: Temporary Approximately 4 months, through February 2027

Position Overview

Friday Services is seeking a Healthcare Program & Claims Support Representative for a temporary assignment supporting a healthcare organizations program and claims operations.

This position combines administrative program support, healthcare data entry, claims processing, provider communication, and customer service. The ideal candidate will be highly organized, detail-oriented, comfortable working with multiple computer systems, and able to handle confidential healthcare information with discretion.

This role will work with members, providers, internal teams, and external stakeholders while ensuring information and claims are processed accurately and within required timelines.

Responsibilities
Program & Administrative Support
Provide administrative and program support to department leadership and staff.
Coordinate information and follow up on assigned tasks to ensure timely completion.
Gather and organize information to support member care, provider services, and department operations.
Enter, update, and maintain information in healthcare management and administrative systems.
Assign members to staff caseloads and assist with referrals and coordination of services.
Maintain accurate files, records, and documentation.
Collect, track, and report data as requested.
Schedule and coordinate internal and external meetings, including preparing and distributing meeting information or minutes.
Assist with scheduling and coordinating travel and other administrative needs.
Communicate professionally with members, providers, government agencies, community partners, and the general public.
Monitor email, fax, mail, and other department communication channels.
Upload documents and add member information to electronic health record and administrative systems.
Assist with departmental purchasing, invoices, supplies, and other administrative functions.
Claims Processing & Support
Review and process paper medical claims for physical and behavioral health services.
Determine whether claims contain the required information for processing.
Enter valid paper claims into the claims adjudication system accurately and within established timelines.
Return or communicate with providers regarding claims that cannot be processed because of missing or invalid information.
Process claim rejections and send appropriate correspondence to providers.
Prepare and send reconsideration letters related to claim appeals.
Review claims for accuracy and identify payment or denial patterns.
Finalize claims for payment and assist with claims reconciliation and quality control.
Review claims for potential adjustments, corrections, or recoupments.
Assist providers with questions or issues related to claims, eligibility, authorizations, overpayments, and payments.
Provide professional customer service to providers and internal staff by phone, email, and other communication channels.
Follow established policies, procedures, fee schedules, and regulatory requirements.
Compliance & Quality Assurance
Maintain a high level of accuracy when entering and reviewing healthcare and claims information.
Monitor work for compliance with established policies and procedures.
Participate in training and department meetings to maintain technical knowledge.
Handle protected health information and other confidential information in accordance with applicable privacy and security requirements.
Maintain accuracy and confidentiality when working with sensitive member and provider information.

Qualifications
Previous experience in healthcare administration, medical claims, insurance, medical billing, or a related field preferred.
Experience working with computerized healthcare, claims, or administrative systems preferred.
Knowledge of medical terminology, including ICD-10, CPT, HCPCS, and revenue codes, is a plus.
Strong computer skills, including Microsoft Word, Excel, Outlook, and PowerPoint.
Excellent attention to detail and accuracy.
Strong written and verbal communication skills.
Ability to work with confidential and sensitive information.
Strong organizational and time-management skills.
Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
Strong problem-solving and analytical skills.
Ability to work independently while also contributing effectively to a team.
Professional and courteous communication with members, providers, internal staff, and external stakeholders.
Ability to learn and apply complex policies and procedures.

Work Environment

This is primarily a sedentary position requiring extended periods of computer work, reading, data entry, and document review. The position may require occasional walking, reaching, crouching, and lifting up to 10 pounds.

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