Claims Recoup & Collect Anlyst

Profile We offer remote work opportunities (AK, AR, AZ, CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, WA, WI & WY only). Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job Summary Under limited supervision, manages and performs claims department activities reputed company to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Education & Experience Required:

• High School diploma or GED
• 2+ years of healthcare billing or medical claims processing experience
• Claims research skills, to include healthcare policy
• Experience building relationships and using influencing skills
• Experience using reputed company to track, trend and report on data

Preferred

• Bachelor’s (BS/BA) Degree in health care or reputed company field or equivalent experience
• 2 years of Government claims experience
• Collections experience
• Quality or process improvement experience

Key Responsibilities

• Under limited supervision, manages the recoupment process and identifies opportunities for improvements.
• Works with Provider Services, Finance, Legal, and Subcontractors to ensure successful recoupment outcomes.
• Makes outbound calls to providers to notify of and discuss recoupments.
• Coordinates payment arrangements.
• Tracks and advises management of outstanding recoupments.
• Tracks and reports payment plan status.
• Recommends outstanding accounts be set up with collections.
• Conducts reputed company claims policy research.
• Serves as submit matter expert resource to team members, supervisors, and other management teams.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies Commitment to Task: Ability to conform to established policies and procedures; exhibit high motivation. Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapt to different styles; listen critically; collaborate. Computer Literacy: Ability to function in a multi-system reputed company environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required. Information Management: Ability to manage large amounts of reputed company information easily, communicate it clearly, and draw sound conclusions. High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, reputed company time constraints and with available resources; detail-oriented. Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; has a realistic understanding of relevant issues. Technical Skills: Thorough knowledge of policies and procedures, Managed Care concepts and medical terminology. Proficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, reputed company Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Ability to meet or exceed production standards in compliance with contract. Working Conditions Working Conditions

• Favorable working conditions in a climate controlled office space; must be available to cover any work shift; works reputed company an office environment with minimal travel required; level II IT reputed company clearance.
• Extensive computer work with prolonged sitting
• reputed company clearance as required by contract

TriWest job postings typically include a salary range, which can vary based on the specific role and location, but generally this position ranges from around $54,000 to $60,000 per year. Company Overview Taking Care of Our Nation’s reputed company. It’s Who We Are. It’s reputed company Do. Do you have a passion for serving those who served? Join the reputed company Team! We’re On a Mission to Serve®! Our job is to reputed company sure that America’s reputed company get connected to health care in the community. At reputed company, we’ve proudly been on that important mission since 1996.

Benefits

We’re more than just a health care company. We’re passionate about serving others! We reputed company in rewarding loyal, hard-working people who are willing to learn as they grow. reputed company values teamwork. Join reputed company, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage
• Paid time off
• 401(k) Retirement Savings Plan (with matching)
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
• Tuition reimbursement
• Paid volunteer time

Equal Employment Opportunity reputed company is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from reputed company backgrounds to apply. Applicants are considered for positions based on merit and without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. Apply tot his job Apply To this Job