Technician, Accounting III

BlueCross BlueShield of South Carolina•Nashville, TN

2d•Onsite

About The Position

A Medicare Claims Overpayment Claims Processor identifies, investigates, and recovers incorrectly paid medical claims by analyzing payment data, verifying overpayments from sources like duplicate payments or system errors, documenting findings, and coordinating with providers for reimbursement or adjustments according to Medicare guidelines. Tasks include Medicare claim adjustments, Medicare Secondary Payer claim adjustments, preparing correspondence, creating, and updating accounts receivables and reviewing reports. This role requires strong analytical and communication skills, knowledge of medical terminology and claims processing, and the ability to maintain organized records and report on recovery efforts to ensure timely collection of overpayments funds.

Requirements

Bachelor's degree in Accounting/Finance. or Associate’s degree in Accounting/Finance plus 2 years of experience supporting accounting or financial operations OR 4 years of experience supporting accounting or financial operations.
Good oral and written communication and customer service skills.
Excellent organization skills and attention to detail.
Strong business math skills.
Microsoft Office.

Nice To Haves

Experience in Claims Processing and HIGLAS, highly preferred.

Responsibilities

Prepares various in-depth financial data associated with refunds, invoices, recoupments, adjustments, cash disbursements, deposits, check voids and reissues, disputes, correspondence, or other data in support of the finance or accounting function.
Ensures data is complete, accurate, and organized for processing.
Provides supervisor with daily, weekly, and/or monthly summary reports of accounting activities for the position.
Completes moderately difficult to complex research using financial reporting systems, files, and other means to identify errors such as overpayments or misapplication of funds.
Resolves most questions and problems, referring most complex issues to higher levels.
Performs calculations on financial documents to ensure accuracy of bank deposits, receipts, disbursements, refunds, or other accounting-related items.
Provides other support duties related to the accounting/finance function that may include monitoring financial systems, tracking funds, balancing accounts, maintaining inventory and receiving cash funds from customers, etc.
Assists less experienced accounting clerks as needed.
Prepares journal entries and account reconciliations.
Responds to telephone and written inquiries from internal and external customers to ensure accurate billing, payments and/or collections.