Specialist, Claims Recovery / collections - (Spokane, WA)

* RecoverySpecialist are Responsible for reviewing Medicaid, Medicare and Marketplaceclaims for over payments * Workingknowledge of claims processing, payments, multiple State billing guidelines andclaims processing policies and procedures. * Researchingclaim payment guidelines, billing guidelines, audit results, multiple state andfederal regulations to determine over payment accuracy and provider compliance * Alsoresponsible for verbally interacting with providers (Recovery call center),health plans, and vendors to recover outstanding over payments. * Postingof refunds and auto deducting provider claims Job description Responsible for administering claims payments, maintaining claim records, and providing counsel to claimants regarding coverage amount and benefit interpretation. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards.