Claims Finance Specialist

Description EXPECTED WORK AND PERFORMANCE • Submission of request for funds (RFFs) for clients based on schedule or delivery. • Submission of client invoices. • Work collaboratively with Finance for the reconciliation of the clients funding accounts. • Provide low balance client account information to the Account Management team. • Assist with voids, refunds, and recoupments from overpaid claims. • Assist with the resolution of escalated, DOI, OIG, OIC, and BBB complaints and appeals. • Process first submission claims requiring re-adjudication. • Audit provider accounts to confirm open receivables and payables and effectively communicate balances either directly to the provider or to an internal provider relations team member. QUALIFICATIONS Required • Advanced computer skills and experience with MS Application – Adobe, Excel, Word, Outlook is required. • Accounts Receivable, Audit, Claims Payment and/or Revenue Cycle Management experience. • Minimum 2-year administrative office experience. Preferred • Associate degree or equivalent combination of education and experience. • Claims Processing Background. SKILLS • Strong mathematical skills. • Understanding basic principles of finance, accounting, or bookkeeping. • Extremely organized with the ability to effectively manage multiple tasks. • Self-motivated and the ability to work independently with minimal supervision