Job Description
We are seeking a skilled professional to manage claims and recover overpayments from hospital, ancillary and overseas medical providers. The successful candidate will work closely with customers and providers to resolve complex issues and achieve positive outcomes.
This role involves reviewing and assessing overpayments, identifying areas of actual and potential claims leakage, and recommending system changes. The ideal candidate will have experience working with insurance or hospital claims systems and advanced skills in excel to manipulate claims adjustments.
The team you will be joining is responsible for managing a significant annual portfolio through identification, verification, recovery, and reconciliation activities. You will work collaboratively to achieve team targets and business goals, utilizing clear communication skills to manage complex conversations with providers and customers.
Main Responsibilities:
* Claims Advice and Expertise: Provide expert advice on claims identification, assessment, and recovery
* Claims Debt Management: Manage a claims debt management portfolio, closing outstanding cases
* Communication and Collaboration: Utilize clear communication skills to manage complex conversations with providers and customers
* Risk Pattern Identification: Identify and manage customer and provider refunds, as well as claim reconciliation activities