Claims Recovery Speciliast

TEKsystems • Tampa, FL

6d • $26 - $27 • Hybrid

About The Position

The Claims Recovery Specialist is responsible for identifying, investigating, and recovering overpayments made to healthcare providers within the workers' compensation industry. This role owns the recovery process from discovery through resolution, utilizing extensive workers' compensation knowledge to analyze claims, payment activity, reimbursement methodologies, fee schedules, provider disputes, and contractual requirements to maximize recovery opportunities and protect client and company assets.

Requirements

• Extensive workers' compensation knowledge

Responsibilities

• Identify, investigate, and validate claim overpayments made to healthcare providers.
• Manage recovery cases from identification through resolution, ensuring timely follow-up and closure.
• Review claims, bills, payment histories, explanations of reimbursements (EORs), contracts, and supporting documentation to determine recovery opportunities.
• Prepare and send recovery letters, refund requests, and related correspondence to providers.
• Conduct outbound calls and email outreach to providers to discuss outstanding recovery balances and facilitate reimbursement.
• Research and resolve recovery-related inquiries, disputes, and provider concerns.
• Collaborate with internal departments, including Bill Review, Accounting, Client Services, Network Services, Legal, and Operations, to support recovery efforts and resolve complex issues.

Benefits

• Medical
• dental
• vision
• Critical Illness
• Accident
• Hospital
• 401(k) Retirement Plan
• Pre-tax and Roth post-tax contributions
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed