Remote Overpayments Recovery Specialist

Centene Corporation; Illinois; Remote; USD 52,000 - 68,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible remote/hybrid/work schedule

Job summary

Centene Corporation is seeking a Recovery Analyst to identify, research, and investigate potential claims overpayments to support the Claims Recovery function. The role requires at least one year of claims processing experience and an undergraduate degree or equivalent.

Applicants may work remotely from anywhere in the United States. You will interact with providers, vendors, and internal teams to collect overpayments, prepare data-driven reports, and ensure accuracy in payments while complying

Qualifications

• One year of claims processing experience in a high production environment.
• Undergraduate degree or equivalent experience.

Responsibilities

• Identifies, researches and investigates possible claims overpayments from reports prepared by internal and external sources.
• Determines compliance with benefit plans, provider contracts, and policies and procedures as they relate to the accuracy of claim payments.
• Summarizes results of research to support collection of overpayments from providers.
• Interacts with providers regarding collections, adjustments, problems, etc.
• Interacts with outsourced vendors and supports their efforts in identifying overpayments.
• Reports additional areas where overpayments may exist based on performed work.
• Prepares reports by extracting data to investigate additional exposure areas.
• Monitors and controls exception amounts sent to providers for collection.
• Reviews cash receipts recorded by Finance for amounts misdirected.

Skills

Claims processing

Data analysis

Provider communications

Education

Undergraduate degree or equivalent

Job description

Centene Corporation is seeking a Recovery Analyst to identify, research, and investigate potential claims overpayments to support the Claims Recovery function. The role requires at least one year of claims processing experience and an undergraduate degree or equivalent.

Applicants may work remotely from anywhere in the United States. You will interact with providers, vendors, and internal teams to collect overpayments, prepare data-driven reports, and ensure accuracy in payments while complying