Top 9057 Account Claims Associate Jobs

Claims Recovery Specialist II (Remote)
CareFirst BlueCross BlueShield —Baltimore, MD
- $42,624 - $78,144 a year
- Full-time
- Remote
- Basic math
- Mid-level
- High school diploma or GED
- 401(k)
Quick Apply
11d
Medical Claims Payment Posting, Reconciliation Specialist
Abby Care —San Francisco, CA
- $60,000 - $70,000 a year
- Full-time
- Remote
- Background check
- HIPAA
- Mid-level
- Commuter assistance
- Paid parental leave
Appeals Specialist II
MedReview —Remote
- $50,000 - $55,000 a year
- Full-time
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- Research
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- Microsoft Office
- Commuter assistance
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Auto Reviewer Variable - Virtual & Desk
Alacrity Claims Solutions, LLC —Remote
- From $40,000 a year
- Overtime
- Background check
- Customer service
- Computer literacy
- Health savings account
- Health insurance
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Associate Claims Representative (Remote)
MEM —Tennessee
- Full-time
- Remote
- No high school diploma
- Mid-level
- High school diploma or GED
- Profit sharing
- Paid jury duty
Member Experience Associate
Fetch Pet Insurance —Remote
- $20.00 - $21.50 an hour
- Full-time
- Remote
- Google Workspace
- Bachelor's degree
- 1 year
- Tuition reimbursement
- Paid time off
Claims Representative II (Remote)
MEM —Tennessee
- Full-time
- Remote
- Mid-level
- 2 years
- Profit sharing
- Paid jury duty
Paralegal
Binghamton Housing Authority —Binghamton, NY
- From $43,500 a year
- Full-time
- Mid-level
- Apartments
- Typing
- Free parking
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Paralegal
Nicolet Law —Milwaukee, WI
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Writing skills
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Attorney - Personal Injury Law
Franklin D. Azar & Associates —Aurora, CO
- $120,000 - $250,000 a year
- Full-time
- Background check
- Writing skills
- Mid-level
- Relocation assistance
- Health insurance
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Revenue Cycle Manager
Nashville Pain & Wellness Center, PLLC —Dickson, TN
- $60,000 - $70,000 a year
- Full-time
- HIPAA
- Mid-level
- 3 years
- Health insurance
- Dental insurance
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5d
City Attorney
City of Nixa —Nixa, MO
- $149,090 - $162,508 a year
- Full-time
- Background check
- Management
- Word processing
- Health savings account
- Health insurance
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OxyChem Insurance Risk Manager
Oxychem —Dallas, TX
- Full-time
- Microsoft Excel
- 6 years
- Microsoft Outlook
Labor and Employment Attorney
Tully Rinckey —White Plains, NY
- $120,000 - $200,000 a year
- Full-time
- Mid-level
- In-person
- 2 years
- Health savings account
- Health insurance
Quick Apply
Branch Sales Associate
Carrier Enterprise —Herndon, VA
- Part-time
- Marketing
- Computer literacy
- Residential
- Health savings account
- Paid holidays
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Senior Medical Claims Processor
CHRISTUS Health (IHE/Hosted) —Irving, TX
- $20.83 - $25.00 an hour
- Full-time
- Mid-level
- 3 years
- Analysis skills
- Health savings account
- Health insurance
Quick Apply
Attorney
Litchfield Cavo LLP —Providence, RI
- $105,000 - $130,000 a year
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Analysis skills
- Health savings account
- Health insurance
Quick Apply
Catastrophe Claims Supervisor
Shelter Insurance —Topeka, KS
- $69,264 - $88,645 a year
- Full-time
- Management
- Mid-level
- 3 years
- Profit sharing
- Wellness program
9d
Accounting Specialist
Preston Feather Building Centers —Petoskey, MI
- Part-time
- Background check
- Pass drug screening
- Mid-level
- Profit sharing
- Employee discount
Quick Apply
8d
Outside Sales Rep (Ohio)
Neenah Foundry Company —Neenah, WI
- From $73,500 a year
- Weekends as needed
- Background check
- Clean driving record
- Microsoft Excel

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Claims Recovery Specialist II (Remote)

CareFirst BlueCross BlueShield -
Baltimore, MD

Quick Apply

Job Details

Full-time
$42,624 - $78,144 a year
11 days ago

Benefits

401(k)

Qualifications

Direct client contact
High school diploma or GED
Internal employee customer service
Customer engagement
Individual consumer customer service

Full Job Description

Resp & Qualifications

PURPOSE:
Under minimal supervision, the Claims Recovery Specialist II review and audits medical and/or dental claims to recover payments. Specialist will assist to maximize recovery amounts due to refund of payments made in error to members and/or providers, retro terms and/or focused provider audits. Specialist will provide day-to-day management of active overpayment recoveries. This position will work closely with the claims, service, finance, and vendor auditing departments to complete claims adjustments.

ESSENTIAL FUNCTIONS:

Under supervision, reviews, audits, and/or initiates recovery efforts for medical, and/or dental claims to recover overpayments, ensuring all parts of the process are documented properly.
Contacts carriers, members and/or providers, via phone, email, and correspondence, to recover and settle overpaid and/or unpaid claims. Responds to carrier, customer and/or provider service inquiries regarding outstanding claims and/or overpayment balances. Proactively identifies needs and responds appropriately through investigating, problem solving, engagement of other internal or external resources, and providing high level service. Adjusts claims to reflect cash returned by members and/or providers to reduce and accurately reconcile customer accounts.
Distributes written correspondence to policy holders to recoup overpaid claims, negotiate repayment agreements when necessary, and ultimately reduce the company's care line. Performs vendor education and training to educate vendors on claims retrieval systems and procedures, general vendor updates.
Participate in all internal/external meetings relating to Audit and Recoupment. Improves claims audit and recoupment job knowledge by attending training sessions. Participates with department management in revising Audit and Recoupment SOPs.

QUALIFICATIONS:

Education Level: High School Diploma or GED.

Experience: 5 years claims processing.

Preferred Qualifications:

1 year adjustment processing

Knowledge, Skills and Abilities (KSAs)

Mathematical ability/aptitude.
Communication skills.
Ability to deal with both internal and external clients.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Salary Range: $42,624 - $78,144

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

Quick Apply

Refine Your Search

Account Claims Associate jobs

Claims Recovery Specialist II (Remote)

Medical Claims Payment Posting, Reconciliation Specialist

Appeals Specialist II

Auto Reviewer Variable - Virtual & Desk

Associate Claims Representative (Remote)

Member Experience Associate

Claims Representative II (Remote)

Paralegal

Paralegal

Attorney - Personal Injury Law

Revenue Cycle Manager

City Attorney

OxyChem Insurance Risk Manager

Labor and Employment Attorney

Branch Sales Associate

Senior Medical Claims Processor

Attorney

Catastrophe Claims Supervisor

Accounting Specialist

Outside Sales Rep (Ohio)

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