Overpayment Recovery Specialist

Blue Cross Blue Shield of Kansas; Topeka (KS); On-site; USD 29,000 - 36,000; Full time

Benefits offered by this job

Base compensation in total rewards

EPIP incentive pay

Health/Vision/Dental insurance

6 weeks paid parental leave

Fertility/Adoption assistance

2 weeks paid caregiver leave

401(k) plan matching up to 5%

Tuition reimbursement

Health & fitness benefits

Job summary

Blue Cross and Blue Shield of Kansas is seeking a Payment Recovery Correspondent to analyze and determine corrective actions for improperly processed claims. This onsite role in Topeka requires coordinating with Claims and Finance to recover overpayments and issue accurate collection letters.

You will work with various systems and data sources to balance accounts and respond to inquiries from internal and external customers.

Qualifications

• High School diploma or equivalent required.
• Minimum one year experience in Claims or BCBSKS Customer Service required.
• Must be proficient in the systems used by the department after training.

Responsibilities

• Conduct audits of claims processed to assure adherence to processing policies and guidelines.
• Pursue and manage recovery of overpayments and apply recoveries.
• Collaborate between the Claims and the Finance departments to ensure proper accounting of returned checks, addresses for providers, and refunds.
• Generate Collection Letters for all lines of business.
• Research ACES/CSI, eligibility, history, and purged history to identify the claim(s) that need adjusted upon receipt of an unidentified refund check.
• Create and route CSI/OTIS & Image to other areas for claim adjustments.
• Update the Workday system with the appropriate transactions to close open payments, debits, and credits to keep corporate accounting in balance.
• Respond to telephone and written inquiries in a courteous, timely, and accurate manner for both internal and external customers.

Skills

Independent work

Team collaboration

Mathematical accuracy

Written & verbal communication

System proficiency

Multi-line business knowledge

Education

High School diploma or equivalent

Job description

Blue Cross and Blue Shield of Kansas is seeking a Payment Recovery Correspondent to analyze and determine corrective actions for improperly processed claims. This onsite role in Topeka requires coordinating with Claims and Finance to recover overpayments and issue accurate collection letters.

You will work with various systems and data sources to balance accounts and respond to inquiries from internal and external customers.