Specialist, Claims Recovery (Remote)

About the role

This role supports claims recovery activities, collaborating with health plans and vendors to recover outstanding overpayments. Key responsibilities include preparing notifications, validating claims, and managing the claims process.

Responsibilities

• Prepares written provider overpayment notifications and supporting documentation.
• Maintains and reconciles department reports for outstanding payments, past-due overpayments, uncollectible claims, and autopayment recoveries.
• Enters and updates recovery applications and claim systems for multiple states.
• Completes basic validation on claims payments using various resources.
• Enters and updates claim systems for refunds or auto debits.
• Responds to provider correspondence and completes refund checks and manual check requests.
• Supports claims department initiatives to improve efficiency.
• Meets quality and production standards for claims projects.

Requirements

• At least 1 year of experience in a clerical role in a claims or customer service setting, preferably in managed care.
• Research and data entry skills.
• Organizational skills and attention to detail.
• Time-management skills and ability to manage simultaneous projects.
• Customer service experience.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Qualifications

• At least 1 year of experience in a clerical role in a claims or customer service setting, preferably in managed care.
• Research and data entry skills.
• Organizational skills and attention to detail.
• Time-management skills and ability to manage simultaneous projects.
• Customer service experience.
• Effective verbal and written communication skills.
• Proficiency in Microsoft Office suite and applicable software programs.

Skills

• Claims recovery experience.
• Health insurance experience in a managed care setting.

Benefits

The company offers a competitive benefits and compensation package, including a pay range of $13.41 - $29.06 per hour.

Pay

$13.41 - $29.06 / HOURLY

Schedule

N/A

Benefits

N/A

Skills

• Claims recovery experience.
• Health insurance experience in a managed care setting.