Strategic Claims Recovery & Receivables Specialist

Western Growers; Irvine (CA); On-site; USD 55,000 - 75,000; Full time

Job summary

Western Growers is seeking a Claims Receivables and Recovery Specialist to collaborate with the Supervisor, Payment Integrity, and multiple departments to pursue and collect open receivables resulting from claim overpayments or adjustments.

You will handle approvals, presentations of receivables for decisions, and maintain comprehensive process documentation while generating monthly reports and supporting audits and process improvements.

Qualifications

• Experience handling medical/dental/vision claim overpayments and refunds.
• Ability to research, review, and analyze receivables and provide timely responses.

Responsibilities

• Research, review and analyze all overpayments, refunds and voids relating to medical, dental, and vision claims.
• Collect receivables for WGAT and TPA clients by researching, writing letters, and making calls.
• Process refunds and perform voids and reissues as needed.
• Review and analyze statistical data related to claim history.
• Respond to inquiries from other departments within turnaround times.

Skills

Receivables management

Data analysis

HIPAA compliance

Communication

Job description

Western Growers is seeking a Claims Receivables and Recovery Specialist to collaborate with the Supervisor, Payment Integrity, and multiple departments to pursue and collect open receivables resulting from claim overpayments or adjustments.

You will handle approvals, presentations of receivables for decisions, and maintain comprehensive process documentation while generating monthly reports and supporting audits and process improvements.