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. Logistics: CGS (cgsadmin.com) – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time position (40-hours/week) working an 8hr shift Monday-Friday within the hours of 6:00am-5:30pm central time at 26 Century Blvd Suite ST610 Nashville TN 37214 in an office environment. Internal employees who are currently working remote may continue to work remotely. Internal employees working in office can potentially work a hybrid schedule (3 days in office, 2 days work from home). SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). To comply with the McNamara-O'Hara Service Contract Act (SCA), employees must enroll in our health insurance even if they have other health insurance. Employees will receive supplemental pay for health insurance until they are enrolled in our health insurance, first of the month following 28 days after the hire date.

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.