The CSI Companies, Inc, a leading National Professional staffing agency is currently hiring a Claims Recovery Collector. As the claims recovery collector you will be responsible for recovering payments from commercial insurance carriers who should have paid primary to the Medicaid agency.
This is a contract role that starts in late July, and will continue through the end of the year. It's full time, business hours.
- Confer with carriers by telephone or use Web sites to determine member eligibility and claim status.
- Assess denials, pursue appeals or close claims when appropriate.
- Update case management system with proper noting of actions and appeal/denial information.
- Respond to carrier telephone, fax and e-mail inquiries regarding outstanding claims.
- Sort and file correspondence.
- Mail form letters to carriers to affect payment of outstanding claims
- Contact providers to obtain additional information and/or documentation to resolve unpaid claims.
- Manage a weekly aging report.
- Responsible for achieving high recoveries against a portfolio of claims.
- Ensure that payers adhere to laws regarding timely filing of claims
- Pursue each outstanding account to reach maximum reimbursement by working with subject matter experts to resolve challenging claims
- Develop recovery strategies with each payer
Preferred Knowledge, Skills and Abilities:
- Basic understanding of third-party billing and/or claims processing
.- Ability to use critical thinking skills.
- Possess good customer service skills.- Ability to adapt to change.
- Ability to manage time effectively and multi-task.
- Ability to prioritize work.- Ability to perform basic calculations.
- Ability to work proficiently with Microsoft Windows, Word and have basic knowledge of Excel.
- Ability to perform well in a team environment to achieve business goals.
High School Diploma or GED required, Associates degree preferred
Minimum Related Work Experience:
- 1 year call center experience
- Ability to interpret an Explanation of Benefits (EOB) and UB-04 claim form required
- DSM-IV, CPT, HCPCS, and CMS-1500 preferred
Leasing (Contract Law)