Position Title: Cost Recovery Technician
Open Positions: 1
Posted Date: June 3, 2022
Location: Independence, MO (Landmark Building)
Department: Cost Recovery
Supervisor: Greshan George
Apply online at: https://geha.wd5.myworkdayjobs.com/GEHACareers/job/Landmark---Independence/Cost-RecoveryTechnician_R003653
Summary Analyzes overpayments, documents actions taken and generates reports. Coordinates collection efforts with outside collection and PPO vendors. Manages the WC/MC/OC/Checks backlog and incoming correspondence and backs up other positions in the Cost Recovery Department. Works independently under general supervision of the Supervisor, Cost Recovery.
Duties • Reviews and audits overpayments received from the Claims department and reviews possible overpayments involving other coverage and/or workmen’s compensation to determine extent of overpayments. • Researches and reviews member/provider disputes of overpayments. Prepares written response and responds to telephone inquiries and makes outgoing calls to/from members and providers. • Reviews and coordinates overpayments and collections efforts with outside collection vendors and makes determination in accordance with overpayment guidelines. • Adjusts claims and posts refund checks received related to overpayments. Documents appropriate actions in claims processing systems and Macess. • Researches and responds to correspondence received related to overpayments from members and/or providers. • Manages and completes the departments workloads (WC/MC/OC/Checks Backlog). • Balances refunds from vendors, ensures correct fees have been applied and submits to Accounting for vendor payment.
Education Requirements Requires two years (60 hours) of college. Additional years of relevant experience may be considered in lieu of formal education.
Experience Requirements • Requires three years working knowledge of claim adjustments or Cost Recovery experience. • Requires comprehensive knowledge of GEHA contract. • Requires effective written and verbal communications to explain obligations, and negotiate recoveries. • Performs other duties as assigned.
GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual
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orientation, as well as all other characteristics and qualities protected by federal, state, or local law. We celebrate diversity and are committed to creating an inclusive environment for all employees.
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