Remote Claims Recovery Specialist

Customer Service; Albuquerque (NM); On-site; USD 24,000 - 39,000; Full time

Job summary

HCSC is seeking a detail-oriented specialist to research refund checks, out-of-balance entries, and non-negotiated provider checks under supervision. The role requires understanding of complex pricing, contract pricing, and coordination of benefits to ensure accurate reimbursements.

Ideal candidates have strong math, analytical skills, and the ability to handle changing priorities. COB experience is preferred; 2-3 years in health care claims or customer service is a plus.

Qualifications

• Strong mathematical skills and numerical accuracy.
• Ability to identify and resolve discrepancies in COB and provider payments.
• Excellent organizational and time management skills; able to adapt to changing priorities.
• Team-oriented with the ability to work independently when needed.

Responsibilities

• Research refunds, out of balance entries, and non-negotiated checks.
• Potential actions include offsetting, voiding, or reissuing provider checks.
• Work with complex pricing, contract pricing, and coordination of benefits.

Skills

Analytical skills

Problem solving

Mathematical skills

Time management

Teamwork

Adaptability

COB knowledge

Education

High school diploma or GED

Job description

HCSC is seeking a detail-oriented specialist to research refund checks, out-of-balance entries, and non-negotiated provider checks under supervision. The role requires understanding of complex pricing, contract pricing, and coordination of benefits to ensure accurate reimbursements.

Ideal candidates have strong math, analytical skills, and the ability to handle changing priorities. COB experience is preferred; 2-3 years in health care claims or customer service is a plus.