Claims Recovery Examiner

Health Care Service Corporation; Albuquerque (NM); On-site; USD 25,000 - 39,000; Full time

Job summary

Health Care Service Corporation in Albuquerque, NM is seeking a COB specialist to research refund checks, out-of-balance entries and non-negotiated checks under supervision. You will coordinate benefits and analyze pricing aspects as part of the reimbursement process.

We value strong mathematical and analytical skills, organization, and teamwork, with opportunities for professional development within a purpose-driven, equal-opportunity environment.

Qualifications

• High school graduate or GED.
• 1 year experience of coordination of benefits (COB) experience
• Ability to determine health care reimbursement methodologies and coordinate benefits.
• Organizational and time management skills; flexibility in dealing with changing priorities.
• Team skills, including the ability to work with other or work independently as warranted by the task.
• Strong mathematical skills.
• Strong problem solving and analytical skills.

Responsibilities

• Under supervision, this position is responsible for researching refund checks, out of balance entries and non-negotiated checks. The research may result in action including offsetting, voiding or reissuing provider checks.

Skills

COB knowledge

Coordination of benefits

Analytical skills

Mathematical skills

Teamwork

Time management

Education

High school graduate or GED

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Under supervision, this position is responsible for researching refund checks, out of balance entries and non-negotiated checks. The research may result in action including offsetting, voiding or reissuing provider checks. The processes require knowledge of complex pricing, contract pricing and coordination of benefits.

Job Requirements

• High school graduate or GED.
• 1 year experience of coordination of benefits (COB) experience
• Ability to determine health care reimbursement methodologies and coordinate benefits.
• Organizational and time management skills; flexibility in dealing with changing priorities.
• Team skills, including the ability to work with other or work independently as warranted by the task.
• Strong mathematical skills.
• Strong problem solving and analytical skills.

Preferred Job Requirements

• 2 years progressive responsibility in IHS Department claims processing or Customer Service areas.
• 2 years of accounting experience or good understanding of accounting practices or 2 years of progressive responsibility in claims processing to include COB processing.
• Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act of 1934 (title 25, USC Section 472) Native American Indian Preference shall apply to this position pursuant to the Indian Self-Determination and Education Assistance Act (24 U.S.C. 450, et seq.), 25 CFR 271.44 and other relevant laws (title 25, INJLF

Compensation: $17.75 - $28.39

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.