Remote Claims Recovery Specialist I - Overpayments & Audits
CareFirst BlueCross BlueShield
- Remote job
CareFirst BlueCross BlueShield is seeking a Claims Recovery Specialist I to review and audit medical and dental claims to recover overpayments and manage active recoveries. You will work with claims, service, and finance teams to adjust claims and document processes. Under supervision, you will communicate with members, providers and carriers by phone and email to negotiate repayment plans and finalize adjustments, while following federal and local mandates. #J-18808-Ljbffr CareFirst BlueCross BlueShield
$35.71k - $65.47k
PURPOSE Under direct supervision, the Claims Recovery Specialist I review and audits medical and/or dental claims to recover payments. They will provide day-to-day management of active overpayment recoveries. Specialist will work to maximize recovery amounts due to refund...Remote jobWork experience placementLocal area- EmblemHealth Remote position seeks a Health Care Claims Data Analyst to develop business requirements for queries... ...leverage post-claim editing and recovery programs. You will analyze claims,... ...payments, and vendor data to identify overpayments, support cost containment, and...Remote job
- ...Services seeks a Third Party Liability Specialist to review and analyze medical assistance claims, ensuring funds are used properly and recovering overpayments. You will join a team protecting... ...negotiations to maximize recoveries, with telework options part-time and...Remote jobPart time
- Medica is seeking a detail-oriented professional to support claim adjustment and recoupment activities in Minnetonka, MN. The role focuses on processing and reconciling overpayment recoveries, researching discrepancies, and maintaining accurate records in a fast-paced environment...Suggested
- LoanCare, LLC is seeking an Internal Mortgage Claims Analyst to audit and reconcile government-backed mortgage claims, focusing on recoveries and compliance. You will work with FHA,... ...reporting findings to management. This remote role supports scalable claims processing...Remote job
$40.56k - $44.72k
...Come join our amazing team and work remote from home! The Supplemental Claims and Recovery Specialist is responsible for performing financial reconciliation on all liquidated loans. Determine the root cause for all avoidable losses. Analyze multiple data elements in order...Remote workFull timeImmediate startWork from home$45.76k - $58.24k
...inclusion. Our company is fully remote and offers a flexible work... .... Job purpose The Claims Recovery Examiner position will be... ...When needed assist in claims audit activities. Review incoming... ..., and re-request letters of overpayment sent out 30 or more days....Remote workFull timeWork at officeFlexible hours- ...-call Cost Estimator to support disaster recovery programs, including FEMA Public Assistance... ...and relief projects. Assignments may be remote, field-based, or hybrid depending on client... ...to define eligible work and produce audit-ready documentation. #J-18808-Ljbffr Tetra...Remote job
- Strala is seeking a Recovery Specialist to manage uninsured and contractual recovery claims, including motor vehicle accidents and unreturned rental vehicles arising from rental agreements. You’ll investigate the basis for recovery, review supporting documents, and work...Remote job
- All Care To You, a fully remote MSO serving health plans and providers, seeks a Claims Recovery Examiner. You will review, request, and document claim refunds using Access... ...compliance with claims processing rules, timely audits, and producing accurate refund reports. #J-1880...Remote job
$50k - $65k
...be another party's responsibility. Manage recovery files, coordinate with attorneys and... ...resolution. Key Responsibilities: Investigate claims, communicate with carriers and... ...Microsoft Office proficiency. Full-time remote role based in the US. Competitive annual...Remote jobFull timeWork at office- ...not-for-profit health insurer in New York, seeks an experienced Senior Claims Overpayment & Recovery Analyst to drive financial recovery and improve payment accuracy. Your role will involve auditing, data analysis, and collaboration with providers and internal teams to...
$56.16k - $99.36k
...resources. For more information, visit emblemhealth.com . Senior Claims Overpayment & Recovery Analyst Proactively assess and monitor vendor operational... ...present SLA performance results. Perform transactional audits and compliance, operational, and procedural reviews to...Contract workWork experience placementH1bVisa sponsorship- Knowtion Health is seeking a Revenue Recovery Specialist to resolve motor vehicle and health insurance claims from hospital providers. This remote role requires a dedicated home workspace and the ability to multi-task and communicate professionally with payers and attorneys...Remote job
- Position: Billing and Denial Claims Specialist Location: Harwood Heights, IL Remote Status: On-Site Job Id: 532 # of... ...management. Assist with payer audits, reimbursement reviews, and revenue... ...quality, appeal turnaround, and recovery targets. Maintain...Remote workFull timeWork at office
- Remote Summary HMS makes the healthcare system work better for everyone. We fight fraud,... ...beneficiaries. This includes intake, maintenance, claims review and selection, asset investigation... ...documents to progress the case to recovery Meet department objective standards for...Remote workContract workWork at office
$77k - $144k
...provides local underwriting, risk services, claim, marketing and audit services for agents and policyholders... ...Responsibilities The Sr. Claims Specialist is a Subject Matter Expert... ...reserved greater than $500,000. Remote work may be considered for highly qualified...Remote workFull timeContract workWork experience placementWork at officeLocal area$65k - $120k
...provides local underwriting, risk services, claim, marketing and audit services for agents and policyholders... ...The Senior Claims Specialist is responsible for the quality handling... ...Perform other duties as assigned. Remote work may be considered for highly qualified...Remote workFull timeContract workWork experience placementWork at officeLocal areaVisa sponsorship- Elevance Health is seeking a Financial Operations Recovery Specialist II to identify and recover overpayments in claims, balancing accounts and coordinating with COB and Medicare policies. This role emphasizes accuracy, analytical thinking, and collaboration with multiple...Remote jobFlexible hours
- Elevance Health is seeking a Financial Operations Recovery Specialist II to join our team in Virginia with flexible virtual options. The role centers on recovering overpayments, validating claims, and adjusting payables while coordinating with COB, Medicare, and medical...Remote jobFlexible hours
- Trillium Health Resources seeks a Claims Specialist II to analyze and audit claims per NC Medicaid guidelines. The role supports providers by phone/email... ...within NC, is expected. The position offers remote work within North Carolina, standard hours, and benefits...Remote job
- Health Business Solutions (HBiz) is seeking a Contractual Claims Analyst to review and resolve complex reimbursement discrepancies across... ...adjustments, perform disputes and appeals, and document recovery efforts. The role emphasizes analyzing contract terms, reimbursement...Remote jobContract work
- Trillium Health Resources is seeking a Claims Specialist II to perform data analysis, auditing, and adjudication finalization for pre- and post-payment reviews in NC Medicaid and Trillium policies. You will assist providers by phone or email with claims processing questions...Remote job
$63.8k - $78k
...who share these values. What Will You Do? As a Recovery Specialist, you will be responsible for recovering subrogation claims and money owed to Federated from tortfeasors... ...reimbursements. Handle mediation processes remotely and acts as advisor on intercompany arbitration...Remote workTemporary workWork experience placementVisa sponsorshipWork visa- Genpact Ltd. is seeking a Specialist - Insurance - P&C Claims to manage an active portfolio of claims, coordinate with contractors, and support client adjusters in the United States. The role emphasizes process discipline, quality review of contractor estimates, and ongoing...Remote jobFor contractors
$94k - $176k
...0 - $176000.00 Job Category: Claims Description Liberty Mutual has... ...opening for a Complex Claims Specialist to join our Long-Term Care... ...allocation, ceded reporting and recovery opportunities. Identify and... ...Westborough, MA. We will consider a remote candidate if you do not live...Remote workFull timeWork at officeLocal areaImmediate start- ...Overage, Shortage, and Damage) claims, shipment refusals, and carrier disputes. Audit Proof of Delivery (POD), bills... ...deductions, customer disputes, and overpayments to determine whether credit is... .... Negotiate settlements and recoveries according to carrier liability...
$19 per hour
Accelerated Claims Inc. is seeking an Account Representative (Claims Specialist) to work remotely with one week onsite orientation. You will research, resolve, and secure payment on outstanding medical claims by coordinating with insurance carriers. The role requires strong...Remote jobMonday to Friday$17.88 - $26.73 per hour
LoanCare is seeking a Claims Specialist II to support mortgage claim processing for agencies and investors. The role... ...reconciliation, document validation, tracking payments, QA audits, and research for missing documents. This remote position offers a comprehensive benefits package...Remote jobHourly pay- ...Tokio Marine HCC group company, is seeking a Claims Processing Auditor to join our hybrid... ...West Des Moines, IA or Lenexa, KS. You will audit and process claims, ensure documentation,... ...schedule with in-office Mon-Thu and remote Fridays. #J-18808-Ljbffr Tokio Marine HCC...Remote workWork at office
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