Claim Overpayment Recovery Specialist II

Medica; Hopkins (MN); On-site; USD 38,000 - 56,000; Full time

Benefits offered by this job

Medical benefits

Paid time off

Job summary

Medica is seeking a detail-oriented professional to support claim adjustment and recoupment activities in Minnetonka, MN. The role focuses on processing and reconciling overpayment recoveries, researching discrepancies, and maintaining accurate records in a fast-paced environment.

The ideal candidate will have 2+ years of administrative or claims experience, strong MS Office skills, and the ability to work both independently and as part of a team.

Qualifications

• High school diploma or equivalent.
• 2+ years of related administrative, claims, financial, operations, or related experience.
• Experience with health insurance claims or claim operations.
• HealthRules experience strongly preferred.
• SharePoint experience.
• Experience handling financial transactions, cash handling, payment processing, or reconciliation activities.
• Experience in healthcare, insurance, banking, accounting, or related operational environments.
• Familiarity with claim adjustment, overpayment recovery, or recoupment processes.

Responsibilities

• Process and reconcile claim overpayment recoveries, including receiving, reviewing, and posting returned checks
• Research and resolve issues related to claim adjustments, recoupments, and payment discrepancies
• Manage daily inventory of assigned work and meet productivity expectations while maintaining accuracy
• Handle physical checks and ensure appropriate controls are followed for large dollar amounts
• Utilize internal systems and established procedures to investigate and resolve claim-related issues
• Work collaboratively within a shared team environment, including management of a shared email inbox
• Maintain organized workflows and support inventory turnaround goals
• Partner with Finance and other internal stakeholders as needed to resolve payment and recoupment issues
• Follow departmental policies, procedures, and standard operating processes to ensure compliance and consistency
• Assist with bad address research and other administrative processes related to claim recoveries

Skills

Attention to detail

High-volume workload management

Organizational skills

Time management

Microsoft Office proficiency

Independent work

Written and verbal communication

Education

High school diploma or equivalent

Tools

HealthRules

SharePoint

Microsoft Office

Job description

Medica is seeking a detail-oriented professional to support claim adjustment and recoupment activities in Minnetonka, MN. The role focuses on processing and reconciling overpayment recoveries, researching discrepancies, and maintaining accurate records in a fast-paced environment.

The ideal candidate will have 2+ years of administrative or claims experience, strong MS Office skills, and the ability to work both independently and as part of a team.