Job Openings in Sacramento County and Beyond

Claims Recovery Analyst

Sacramento, CA

Posted: 01/15/2020 Employment Type: Temp-to-Hire Position Industry: Healthcare/Medical Job Number: 42090.1

Job Description

Our client is in immediate need of a Claims Recovery Specialist to support their busy speciality office in Sacramento. This is a temporary to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Claims Recovery Specialist will be responsible for the recovery of any identified claim overpayments, specifically high dollar amounts, be Excel savvy, and have a background in the adjudication of claims.

Responsibilities: Verify accuracy and processing of refund checks. Able to evaluate and review solicited and unsolicited refunds. Post refunds to the system according to guidelines. Generating reports to identify possible overpayments. Maintains log of refunds and recoupments as well as refund checks received and processed. Responsible for reconciliation of refunds by sending follow-up requests on outstanding overpayments at required intervals.

Requirements: Experience with managed care claims processing. HMO and IPA experience required. Strong ICD-9/10, HCPCS, CPT coding, facility and professional claim billing process. Strong Excel knowledge - VLOOKUP and pivot tables. Strong follow through on commitments and meets deadlines. Work is thorough, accurate, and effective. Excellent communication skills, including both oral and written. Ability to pass on boarding requirements including both drug and background screening.
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