JOB RESPONSIBILITIES:
• Research, analyze, and resolve claim overpayment inventory discrepancies in accordance with departmental policies and procedures.
• Perform account reconciliations and financial analysis to identify and resolve outstanding balances, payment discrepancies, and recovery-related issues by collaborating with internal business partners and external stakeholders.
• Review and process manual account adjustments, corrections, and recovery transactions as appropriate.
• Respond to provider, customer, and internal inquiries through phone, email, and written correspondence in a timely, accurate, and professional manner.
• Process, track, and balance returned checks, stop payments, recoupment cash transactions, advance payments, and settlement checks.
• Generate and distribute monthly, quarterly, and semi-annual reports for management and external customers.
• Utilize financial and claims systems to conduct research, validate transactions, and support issue resolution.
• Monitor and coordinate assigned activities performed by offshore staff to ensure quality, accuracy, and adherence to established procedures.
• Document processes, procedures, findings, and resolutions to support operational consistency and compliance requirements.
• Identify process improvement opportunities and recommend solutions to increase efficiency and accuracy.
• Support special projects, audits, account reviews, reconciliations, and ad hoc financial analyses as assigned.