Claims Support Specialist

Claims Support Specialist I page is loaded## Claims Support Specialist Iremote type:
Hybrid - Full Time locations:
Cerritos, CA:
Illinois, USA:
Indiana, USAtime type:
Full time posted on:
Posted 3 Days Agojob requisition :
M102093
** Job Description Summary
** Recovery specialist is responsible for all the claims adjustments recoveries .
** How will you make an impact & Requirements
** May do all or some of the following in relation to cash receipts, cash application, claim audits collections, over payment vendor validation, and claim adjustments. Responsible for the discovery, validation, recovery, and adjustments of claims over payments.
** Primary duties may include, but are not limited to:
*** Audits paid claims for over payments using various techniques including systems based queries, specialized reporting, or other research.
* Responsible for more complex issues such as coordination of benefits, Medicare, and medical policies.
* Works closely with staff from other departments on a regular basis to ensure customer satisfaction.
* Works closely with contract managers to identify and correct contractual issues when applicable.
* May perform collection activities to ensure the recovery of over payments and maintenance of unprocessed cash and accounts receivable processes and all other cash applications as required.
* Researches voluntary refunds for accuracy.
* Requires accurate balancing of all accounts.
** Requirements:
*** Requires a H.S. diploma; 2-4 years of claims processing and/or customer service experience; or any combination of education and experience, which would provide an equivalent background.
* Associate degree or higher level degree preferred
** Compensation:**$17.10to $29.70

At Care More Health, we provide effective Advanced Primary Care and Palliative Care by seeing the whole person — body, mind, and spirit. We do it with doctors and nurses who provide personalized and compassionate care, nationally recognized disease prevention and management programs, and healthy-living plans. It helps patients get healthier, while receiving the healthcare experience they’ve always wanted.

Mosaic Health is a national care delivery platform focused on expanding access to comprehensive primary care for consumers with coverage across Commercial, Individual Exchange, Medicare, and Medicaid health plans. The Business Units which comprise Mosaic Health are multi-payer and serve nearly one million consumers across 19 states, providing them with access to high quality primary care, integrated care teams, personalized navigation, expanded digital access, and specialized services for higher-need populations.

Through Mosaic Health, health plans and employers have an even stronger care provider partner that delivers affordability and superior experiences for their members and employees, including value-based primary care capacity integrated with digital patient engagement and navigation. Each of the companies within Mosaic Health provide unique offerings that together promise to improve individuals' health and wellbeing, while helping care providers deliver higher quality care.

For more information, please visit  Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

If you require an accommodation for the application or interview process, please let us know and we will work with you to meet your needs. Please contact  for assistance.
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