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Claims Recovery Specialist I
Ref No.: 18-11114
Location: Spokane, Washington
Start Date / End Date: 09/17/2018 to 12/16/2018
Request ID: 3031-1
Job Title: Claims Recovery Specialist I
Duration: 3 Months
Location: Spokane, WA 99201

Job Description:
  • 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.
  • Working knowledge of claims payment, multiple State billing guidelines and claims processing policies and procedures.

Required Education:
  • Require High School Diploma or equivalent
  • Some college preferred in related areas

Required Experience:
  • 2+ years experience in claims adjudication, Claims Examiner II or other relevant work experience
  • Recovery Experience preferred
  • Minimum 1 + year experience in customer service
  • Minimum 1+ year experience in Healthcare Insurance environment with Medicaid, and Managed Care experience • Strong technical skills with Excel and Word
  • Strong verbal and written communication skills