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Claims Recovery Specialist

Location : Spokane, WA
Job Type : Contract
Reference Code : 7895
Hours : Full Time
Travel : No
Relocation : No

Job Description :
Major healthcare organization has an exciting opportunity for a Claims Recovery Specialist in Spokane, WA.

 

Identify, validate and track overpayments to providers by reviewing claims audits results and provider claims reports. 

Handle occasional Provider communication regarding overpayment disputes. 

Coordinate analyzing claims overpayments not to exceed 1 year and determine collection recovery strategies. • 

Prepare written provider overpayment notification and supporting documentation such as explanation of benefits, claims and attachments. • 

Contact providers and handle collection arrangements for overpayment claimants that have not responded to overpayment requests. • 

Handle inquires and responses from internal and external callers. • 

Maintain and reconcile department reports for outstanding payments collected, past-due overpayments, uncollectible claims, and auto-payment recoveries. • 

Prepare and provide write-off documents that are deemed uncollectible or collections efforts are exhausted for write off approval. • 

Participate in health plan meetings to review recovery status updates. • Conduct Special Projects as assigned. 



Requirements

Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA) • Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers Required Education: AA degree or equivalent 

0-2 years in Claims collections recovery and/or claims auditing. Thorough knowledge of various claims payment methodologies. Medicaid, Medicare or Managed Care experience required.



For immediate consideration please email Chad Zelinski: czelinski@xfiregroup.com

 

 
Required Qualifications :
 
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* Your eligibility for benefits depends upon your placement, hours billed and length of service. Your recruiter can identify the programs for which you are eligible. The Company reserves the right to modify or eliminate any of its non-legally mandated benefits at any time.