Claims Recovery Examiner
Core
Research refund checks, out of balance entries, and non-negotiated checks to determine actions like offsetting, voiding, or reissuing provider checks.
Role type
Claims Recovery Examiner
Builds
Provider check adjustments and corrections
Domain
Health insurance claims processing
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Coordination of benefits (COB), health care reimbursement methodologies, complex pricing knowledge, contract pricing knowledge, mathematical skills, problem solving, analytical skills
Preferred skills
Accounting practices, claims processing experience
Responsibilities
Research refund checks, out of balance entries, and non-negotiated checks; Determine actions including offsetting, voiding, or reissuing provider checks; Coordinate benefits using complex pricing and contract knowledge
