Claims Recoupment Specialist II

Medica; Minnetonka (MN); On-site; USD 38,000 - 64,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

PTO & Holidays

401K contributions

Volunteer time off

Job summary

Medica, a nonprofit health plan serving Minnesota and surrounding states, seeks a Detail‑driven Claims Adjustment & Recoupment II to process and reconcile claim overpayment recoveries. You will handle live checks, research discrepancies and post settlements in a fast-paced, collaborative team.

Onsite presence at Minnetonka, MN is required, with a focus on accuracy and efficient workflow management. The role emphasizes high-volume processing, strict controls for large dollar amounts, and

Qualifications

• High school diploma or equivalent required.
• 2+ years of related administrative, claims, financial, operations, or related experience.
• Experience working with health insurance claims or claim operations preferred.
• HealthRules experience strongly preferred.
• SharePoint experience preferred.
• Experience handling financial transactions, cash handling, payment processing, or reconciliation activities.

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 controls for large dollar amounts.
• Utilize internal systems and procedures to investigate and resolve claim-related issues.
• Collaborate within a shared team environment and manage a shared email inbox.
• Maintain organized workflows and support inventory turnaround goals.
• Partner with Finance and other internal stakeholders to resolve payment and recoupment issues.
• Follow departmental policies and standard operating processes to ensure compliance.
• Assist with bad address research and other administrative processes related to claim recoveries.

Skills

Attention to detail

High-volume workload

Organizational/time management

Microsoft Office

Written and verbal communication

Independent yet collaborative

Education

High school diploma or equivalent

2+ years related admin/claims/financial experience

Tools

HealthRules

SharePoint

Job description

Medica, a nonprofit health plan serving Minnesota and surrounding states, seeks a Detail‑driven Claims Adjustment & Recoupment II to process and reconcile claim overpayment recoveries. You will handle live checks, research discrepancies and post settlements in a fast-paced, collaborative team.

Onsite presence at Minnetonka, MN is required, with a focus on accuracy and efficient workflow management. The role emphasizes high-volume processing, strict controls for large dollar amounts, and