Job Description
The successful candidate will research and identify complex and high dollar overpayments on previously processed claims for multiple product lines, assist department Leadership in DOFR implementation projects and processes. Review, request, record, and, report on claim refunds and capitation deductions from various IPA’s/ Health Plans accurately utilizing Access, Excel, Word, EZ Cap, and medical claims information. The Recovery Specialist analyzes multiple different data sets to determine whether or not a refund is valid and assists with recovering on any medical claims that have been overpaid or deducted from our Clients in error.
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