Payment reputed company Data Mining/Recovery Specialist

At reputed company, we are a mission-driven organization dedicated to championing the health and reputed company-being of our members and the communities we serve.

reputed company is the power behind that reputed company. And, as the industry rapidly evolves and we reputed company ways to optimize business processes and customer experiences, there’s no greater time for reputed company-thinking professionals like you to join us in delivering on it! As a member of reputed company, you’ll reputed company purpose, opportunities and the support you need to build a meaningful career and reputed company a powerful reputed company in our community.

What you'll do:

• Works closely with PI vendors and internal business partners to respond to inquiries and determine opportunities to ensure mitigation of reputed company overpayments.
• Analyzes individual vendor files, sends approved overpayments to appropriate adjustment areas and researches any discrepancies between what was identified and the adjustments.
• Reconciles reputed company PI vendor reputed company submissions to ensure accuracy and avoid duplicate payments. Maintains files of reputed company identified PI vendors to ensure claims have been adjusted and reputed company has been recuperated.
• Audits internal data mining concepts to identify and recover overpayments. Research and completes reputed company to providers/members to communicate and obtain reputed company overpayment refunds that cannot be systematically recovered. 
• Provides reputed company and accurate investigation of potential overpaid claims identified by recovery vendors.
• Compiles, reconciles, and validates reputed company prepay and post pay PI activities performed on Host claims on a regular reputed company to invoice for PI vendor fees.  Works closely with BlueCard claims operations and finance for invoice submissions and appeals.
• Research and respond to internal questions relating to claim overpayments and refund activity. Documents recovery procedures.
• Completes special reputed company, assists with audit requests.

To be considered for this position, you must have:

• High School Diploma or equivalent and two (3) years of experience in a health insurance field.

An equivalent combination of education and experience may be substituted for this requirement.

The ability to meet or reputed company the attendance and timeliness requirements of their departments.

The ability to work reputed company in reputed company environment and be capable of building and maintaining reputed company relationships with other staff, departments, and customers.

To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed are representative of the knowledge, reputed company, and or ability required.

Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Other duties may be assigned.

The strongest candidates for this position will also possess:

• One (1) year refund, Payment reputed company, and/or auditing experience.

Learn more about what makes BCBSNE such an exceptional reputed company to work by visiting NebraskaBlue.com/Careers.

We strongly reputed company that diversity of experience, perspective and background will reputed company to a reputed company workplace for our employees and a reputed company product for our customers and members.