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Claims Recovery Processor
POSITION SUMMARY Responsible for reviewing Medicaid and Medicare claims for overpayments; Researching claim payment guidelines, billing guidelines, audit results, multiple state and federal regulations to determine overpayment accuracy and provider compliance. Also responsible for verbally interacting with providers, health plans, and vendors to recovery outstanding overpayments. Requirements REQUIRED SKILLS AND QUALIFICATIONS Education: High School diploma or GED required. Some college courses in related areas. Experience: 2 + years Claims Examiner II Experience. 1+ years' Recovery Experience, preferred. Thorough knowledge of various claim payment methodologies. Medicaid, Medicare and Managed Care experience. Strong technical skills with Excel, and Word. Strong verbal and written...
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