Claims Recovery Specialist

hace 5 horas


San Francisco, Heredia, Costa Rica Experian A tiempo completo

At Experian, we are committed to unlocking the power of data to create more opportunities for consumers, businesses, and society.

We take pride in being named one of the 100 Best Companies to work for by FORTUNE and recognized as a leader in innovation by Forbes Magazine.

The role of Claims Recovery Specialist is crucial in our efforts to deliver exceptional results for our clients. As part of our team, you will be responsible for monitoring contractual allowances, analyzing appeal opportunities with payers and networks, and reporting appeals performance.

Key responsibilities include:

  • Implementing processes for identifying under-allowed claims using software and other available tools.
  • Reviewing and analyzing EOBs for identified under-allowed claims, verifying applicable contracts, and preparing written and telephone appeals.
  • Batching appeals by payer or network, CPT/HCPCS code combination, error type, or provider.
  • Compiling and submitting appeals, monitoring for proper reimbursement, and tracking recoveries using software.

To succeed in this role, you will need:

  • A high school diploma and some university studies preferred.
  • A minimum of one to two years' experience working with managed care claims and appeals for healthcare professional services.
  • Proficiency in Microsoft Office products, including Word, Excel, and Outlook.

You will also have the opportunity to develop your skills in problem-solving, research, and communication, working effectively with other departments and management to achieve goals.

Experian is an Equal Opportunity and Affirmative Action employer, committed to creating a diverse and inclusive team where everyone feels valued and empowered to bring their whole self to work.



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