Medicare Overpayment Claims Processor
Medicare Overpayment Claims Processor
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
Summary
With general supervision this role is responsible for researching and processing Medicare claim adjustments preparing correspondence managing and updating accounts receivables issuing invoices and reviewing reports.
Description
Position Purpose:
A Medical or Medicare Claims Overpayment Claim Adjusteridentifies investigates and recovers incorrectly paid medical claims by analyzing payment data verifying overpayments from sources like duplicate payments or system errors documenting findings and coordinating with providers for reimbursement or adjustments according to Medicare include Medicare claim adjustments Medicare Secondary Payer claim adjustments preparing correspondence creating and updating accounts receivables and reviewing reports. This role requires strong analytical and communication skills knowledge of medical terminology and claims processing and the ability to maintain organized records and report on recovery efforts to ensure timely collection of overpayments funds.
Logistics:
CGS CGS () one of BlueCross BlueShields South Carolina subsidiary companies.
Location:
This is a full-time position (40-hours/week) working an 8hr shift Monday-Friday within the hours of 6:00am-6:00pm central time at 26 Century Blvd Suite ST610 Nashville TN 37214 in an office environment.
Internal candidates who are currently working remote may continue to work remotely. Internal candidates working in office must work in office.
SCA Benefit Requirements:
BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-OHara Service Contract Act (SCA) employees are required to enroll in health insurance benefits regardless of other insurance coverage. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
What Youll Do:
Prepares various financial data associated with refunds invoices recoupments adjustments cash disbursements deposits check voids and reissues disputes correspondence or other data in support of the finance or accounting function. Ensures data is complete accurate and organized for processing. Provides supervisor with daily weekly and/or monthly summary reports of accounting activities for the position.
Completes moderately difficult research using financial reporting systems files and other means to identify errors such as overpayments or misapplication of funds. Resolves routine questions and problems referring complex issues to higher levels.
Performs calculations on financial documents to ensure accuracy of bank deposits receipts disbursements refunds or other accounting-related items.
Provides other support duties related to the accounting/finance function that may include monitoring financial systems keying journal entries tracking funds balancing accounts maintaining inventory and receiving cash funds from customers etc. May assists less experienced accounting clerks as needed.
Determines prepares and distributes correspondence regarding monies due or erroneously received. Issues refunds as appropriate.
To Qualify for This Position Youll Need:
Required Education: Associates or equivalent in a job-related field.
Degree Equivalency: 2 years job related work experience.
Required Software and tools: Microsoft Office to include proficiency in Excel.
Required Skills and Abilities: Good oral and written communication. Excellent organization skills and attention to detail. Strong business math skills. Typical office environment.
We Prefer That You Have the Following:
MCS (Modernized Claims System) experience.
FISS (Fiscal Intermediary Standard System) experience.
HIGLAS (Healthcare Integrated General Ledger Accounting System) experience.
Our comprehensive benefits package includes the following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
On-site cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies theaters zoos theme parks and more.
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills advance their careers and contribute their unique abilities to the growth of our company.
What to Expect Next:
After submitting your application our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age race color national origin sex religion veteran status disability weight sexual orientation gender identity genetic information or any other legally protected status. Additionally as a federal contractor the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities pregnant individuals individuals with pregnancy-related conditions and individuals needing accommodations for sincerely held religious beliefs provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment please email or call ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Employment Type
Full-Time
