Claims Recovery Examiner

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Job Summary

Under supervision, this position is responsible for researching refund checks, out of balance entries and non-negotiated checks. The research may result in action including offsetting, voiding or reissuing provider checks. The processes require knowledge of complex pricing, contract pricing and coordination of benefits.

Job Requirements

* High school graduate or GED.
* 1 year experience of coordination of benefits (COB) experience
* Ability to determine health care reimbursement methodologies and coordinate benefits.
* Organizational and time management skills; flexibility in dealing with changing priorities.
* Team skills, including the ability to work with other or work independently as warranted by the task.
* Strong mathematical skills.
* Strong problem solving and analytical skills.

Preferred Job Requirements

* 2 years progressive responsibility in IHS Department claims processing or Customer Service areas.
* 2 years of accounting experience or good understanding of accounting practices or 2 years of progressive responsibility in claims processing to include COB processing.

Must demonstrate excellent verbal communication skills, including the ability to confidently conduct outbound calls to obtain additional information, clarify details, and resolve issues. The candidate should communicate clearly, professionally, and effectively while maintaining positive relationships with customers and business partners.

Preference in filling vacancies is given to qualified Indian candidates in accordance with the Indian Preference Act of 1934 (title 25, USC Section 472) Native American Indian Preference shall apply to this position pursuant to the Indian Self-Determination and Education Assistance Act (24 U.S.C. 450, et seq.), 25 CFR 271.44 and other relevant laws (title 25,



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Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range

$17.75 - $28.39

Exact compensation may vary based on skills, experience, and location.

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About HCSC

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that onlyrequests for accommodations in the application processwill be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,
Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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