Primary job is to recoup identified claim overpayments by generating refund requests to providers. Coordinate the posting of refunds received and identify how the refunds are to be posted to the claims. Responsible for tracking outstanding money still owed and the refunds received.
Position Responsibilities:
•Review overpaid claims in order to generate appropriate refund letters to the providers. Ensure the refund requests are generated in a timely and accurate manner.
•Determine what money has been paid versus still owed and coordinate the claim offsetting process as appropriate
•Review refunds received and determine how the money is to be posted to the claims detail lines.
•Coordinate the offsetting process with future claims in order to recoup all money owed
•Track all money owed and refunds received by project.
Skill Requirements and Preferences:
•General understanding of claims processing
•Strong written and oral communication skills
•Can effectively communicate with the other key areas in the organization and to providers
•Strong organizational skills
•Can handle multiple priorities
•Analytical and reasoning skills required
•MS Word and Excel knowledge
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