Claims Finance Specialist - Contract

Careington International Corporation • Frisco, TX

8d

About The Position

This role involves managing financial processes related to client claims, including submitting requests for funds, invoicing clients, and reconciling funding accounts. The specialist will also handle client account inquiries, process voids, refunds, and recoupments, and assist in resolving escalated complaints and appeals. Additionally, the role requires auditing provider accounts to confirm balances and processing initial claims for re-adjudication.

Requirements

• Advanced computer skills and experience with MS Application – Adobe, Excel, Word, Outlook is required.
• Accounts Receivable, Audit, Claims Payment and/or Revenue Cycle Management experience.
• Minimum 2-year administrative office experience.
• Strong mathematical skills.
• Understanding basic principles of finance, accounting, or bookkeeping.
• Extremely organized with the ability to effectively manage multiple tasks.
• Self-motivated and the ability to work independently with minimal supervision.

Nice To Haves

• Associate degree or equivalent combination of education and experience.
• Claims Processing Background.

Responsibilities

• Submission of request for funds (RFFs) for clients based on schedule or delivery.
• Submission of client invoices.
• Work collaboratively with Finance for the reconciliation of the clients funding accounts.
• Provide low balance client account information to the Account Management team.
• Assist with voids, refunds, and recoupments from overpaid claims.
• Assist with the resolution of escalated, DOI, OIG, OIC, and BBB complaints and appeals.
• Process first submission claims requiring re-adjudication.
• Audit provider accounts to confirm open receivables and payables and effectively communicate balances either directly to the provider or to an internal provider relations team member.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree