Senior Financial Claims Specialist

hace 3 días


San Francisco, Heredia, Costa Rica People Working Corp A tiempo completo

At People Working Corp, we are seeking a skilled Senior Financial Claims Specialist to join our team. This role is responsible for investigating and resolving overpayment discrepancies, credit balances, returned hospital reimbursement checks, and addressing patient concerns.

This position offers an exciting opportunity to work in a hybrid mode (onsite for the first three months due to probation period and based on metrics) with a dynamic company that values teamwork and professional growth.

Duties:

  • Perform and validate the coding of the reason for the discrepancy.
  • Initiate refunds of identified overpayments and resolve open discrepancies.
  • Monitor returns and initiate timely refunds.
  • Review and resolve credit balances.
  • Accept phone calls and resolve patient questions.
  • Investigate returned refund checks and take steps to resolve them.
  • Identify problematic accounts/processes/trends and escalate them.
  • Use effective documentation standards that support a solid historical record of actions taken in relation to the account.
  • Ability to perform basic mathematical operations that guarantee the accuracy of the account statement.
  • Comply with the organization's productivity and quality standards.
  • Timely complete and understand all educational requirements.
  • Practice and adhere to the philosophy of Code of Conduct and Mission and Values Statement.
  • Other duties as assigned.

Requirements:

  • English Spanish Language (Oral and writing 85% or higher), (B2+ or above).
  • Must have a high school diploma.
  • At least 6 months of experience in Customer Service or Backoffice positions.
  • The resource will adjust its local schedule with the resources supporting this position during Daylight Savings time changes in the Eastern Time Zone.
  • A genuine interest in working with and helping customers.
  • Must possess excellent communication skills and involvement.
  • Good presentation and a polite, tactful, and friendly character.
  • Healthcare experience is a plus.

We offer a competitive salary of $55,000 - $65,000 per year, depending on experience. If you are a motivated and detail-oriented individual who enjoys working in a fast-paced environment, we encourage you to apply for this exciting opportunity.



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