Overpayment Recovery Specialist

CareFirst BlueCross BlueShield; Baltimore (MD); On-site; USD 36,000 - 65,000; Full time

Job summary

CareFirst BlueCross BlueShield in Baltimore, MD seeks a Claims Recovery Specialist I under direct supervision to review and audit medical and dental claims to recover overpayments and manage active recoveries. You will work with claims, service, financial, and vendor auditing teams to complete adjustments.

You will communicate with members, providers, and carriers to recover unpaid claims, document recovery steps, and ensure accurate reconciliation of customer accounts in compliance with

Qualifications

• High School Diploma or GED required.
• 3 years of claims processing experience.
• Experience with overpayment recovery processes is a plus.

Responsibilities

• Review and audit medical and/or dental claims to recover overpayments and manage active recoveries.
• Communicate with carriers, members, and providers to recover and settle unpaid claims and document adjustments.
• Participate in internal/external meetings related to Audit and Recoupment and pursue training to improve knowledge.

Skills

Mathematical ability

Communication skills

Customer service

Education

High School Diploma or GED

Job description

CareFirst BlueCross BlueShield in Baltimore, MD seeks a Claims Recovery Specialist I under direct supervision to review and audit medical and dental claims to recover overpayments and manage active recoveries. You will work with claims, service, financial, and vendor auditing teams to complete adjustments.

You will communicate with members, providers, and carriers to recover unpaid claims, document recovery steps, and ensure accurate reconciliation of customer accounts in compliance with