Sr Claims Financial & Recovery Adjustment Specialist

Sr. Claims Financial & Recovery Adjustment Specialist

SummaCare - 1200 E Market St, Akron, OH

Full-Time / 40 Hours / Days

Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2026 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.

Summary:

Performs necessary tasks to ensure payment accuracy and coordinates recoveries of health insurance claims both internal and external including but not limited to refund posting and void/stale check processes. Maintains accurate documentation and reporting.

Formal Education Required:

• High School Diploma or equivalent

Experience & Training Required:

• Three (3) years progressively responsible experience in health insurance claim processing; general accounting, posting and/or billing; and claims analysis and reporting.

Other Skills, Competencies and Qualifications:

• Word, Excel and Access at a basic level, MS-windows based computer environment. Must achieve passing score on test administered by Human Resources.
• Medical terminology, CPT, HCPC's and ICD-10 coding.
• Understanding of professional (CMS1500) and institutional (UB04) claim types. and unique benefits and processing rules for self-funded, Medicare, MEWA, Marketplace and fully-insured plans.
• Independent judgment and decision-making skills

Level of Physical Demands:

• Sit for prolonged periods of time.
• Bend, stoop and stretch.
• Lift up to 20 pounds.
• Manual dexterity to operate computer, phone and standard office machines.

Equal Opportunity Employer/Veterans/Disabled

$22.61/hr - $27.14/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

• Basic Life and Accidental Death & Dismemberment (AD&D)
• Supplemental Life and AD&D
• Dependent Life Insurance
• Short-Term and Long-Term Disability
• Accident Insurance, Hospital Indemnity, and Critical Illness
• Retirement Savings Plan
• Flexible Spending Accounts - Healthcare and Dependent Care
• Employee Assistance Program (EAP)
• Identity Theft Protection
• Pet Insurance
• Education Assistance
• Daily Pay