Payment Recovery Specialist jobs in Greenwich, CT

Payment Recovery Specialist is responsible for analysis of denied reimbursement claims. Ensures appropriate insurance coverage for compliance standards and revenue generation. Being a Payment Recovery Specialist monitors, evaluates, and reviews all cost reporting in support of claims. Coordinates with departments and insurance companies to correct errors as necessary. Additionally, Payment Recovery Specialist requires a bachelor's degree in area of specialty. Typically reports to a supervisor or manager. To be a Payment Recovery Specialist typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)

X
Manager of Claims Operations/Payment Integrity
  • XO Health Inc.
  • Stamford, CT FULL_TIME
  • ABOUT THE ROLE: 

    The Manager of Claims Operations/Payment Integrity will play a key role in achieving the highest-level of claims excellence through creation and implementation of consistent business processes aligning with strategic goals of the XO Health Operations Department. The Manager of Claims Operations/Payment Integrity will work closely with the SVP of Operations and Payment Integrity and other departments to develop, communicate, implement, execute, and measure claim business processes. 

    RESPONSIBILITIES: 

    • Direct day-to-day operations of claims processing department to ensure that claims are processed within statutory and company guidelines. 
    • Ensure procedural and financial claims metrics and service level agreements are met. 
    • Involved in detecting and correcting claim-based factors such as errors, coding guidelines, fraud, waste, abuse. 
    • Collaborate with leadership from cross functional departments to ensure efficiency and proper prioritization of the claims adjudication process. 
    • Provide regular feedback regarding claim processing performance in critical areas such as compliance policy, process and procedure adherence, and customer satisfaction. 
    • Implement and lead operational improvement efforts that produce successful results in the aforementioned areas. 
    • Coordinate with the Claims Vendor Manager and assist with the development, aggregation, and communication of vendor KPI's and performance. 
    • Assist in the development of claims best practices, including but not limited to, claim processing guidelines, policies and procedures, job aids, and claims bulletins. 
    • Act as a liaison with other departments to obtain and analyze information to further improve claims handling practices and customer relationships. 
    • Monitors performance, reviews open and closed claims to ensure that claims have been properly handled and moved towards resolution in a timely manner. 
    • Supports training of claims examiners, claims managers, and senior claims leadership. 
    • Acts as an SME resource regarding coverage issues, reserves, exposure, settlement value, and strategy. 
    • Submits weekly management reports and prepares special reports when requested. 
    • Responds to inquiries from various other departments with reaction to claim handling, processing, and coverage issues. 
    • Assists in the conducting of audits of vendors, both primary and independent. 
    • Available in an emergency 24/7 and extended hours as needed. 
    • Work with quality assurance personnel and assist as needed. 
    • Assists senior management with other projects and initiatives as requested. 
    • Travel if needed to support train-the-trainer sessions for operational claim staff. 
    • Travel for participation in business management meetings, and support of other business initiatives. 

    EXPERIENCE REQUIRED: 

    The qualified candidate will have: 

    • 5 years of proven medical claims operations leadership experience. Bachelor’s degree in healthcare administration or equivalent relevant work required. 
    • Strong knowledge of medical terminology, health insurance plans, medical billing concepts. 
    • In-depth understanding of Facility, Facility Stoploss, DME, Behavioral Health, Coordination of Benefits claims processing. 
    • Excellent written and oral communication skills. 
    • Excellent customer service and follow-up skills. 
    • Strong organizational leadership skills and detailed oriented. 
    • The ability to manage multiple projects at one time. 
    • Analytical, strategic minded and goal oriented. 
    • A leader with the ability to work independently. 
    • Strong attention to detail. 
  • 10 Days Ago

C
Recovery Assistant
  • CTL
  • Greenwich, CT PART_TIME
  • Summary/ObjectiveFor this role, activities are aimed at reducing the clients debilitating mental illness symptoms, assisting in everyday functioning and help achieve living skills-sets necessary for i...
  • 1 Day Ago

C
Recovery assistant
  • Center For Transitional Living
  • Norwalk, CT FULL_TIME
  • Center For Transitional Living - Job Title : Caregiver Location : Connecticut (CT) Job Type : Full-time or Part-time Job Summary : We are seeking a compassionate and dedicated Caregiver to join our te...
  • 4 Days Ago

I
Event Executive, Partner Marketing (Payment Services Client)
  • IPG DXTRA
  • Stamford, CT FULL_TIME
  • THE JOB / Event Executive, Partner Marketing (Payment Services Client) EXPERIENCES / Responsible for planning and executing event and experiential marketing programs. ***Our headquarters are in Stamfo...
  • 22 Days Ago

C
Event Executive, Partner Marketing (Payment Services Client)
  • Circa - IPG DXTRA
  • Stamford, CT FULL_TIME
  • THE JOB / Event Executive, Partner Marketing (Payment Services Client) EXPERIENCES / Responsible for planning and executing event and experiential marketing programs. ***Our headquarters are in Stamfo...
  • 22 Days Ago

O
Account Trainee, Golf (Payment Services Client)
  • Octagon
  • Stamford, CT FULL_TIME
  • Stamford, Connecticut, United States Requisition ID: 12144 THE JOB / Account Trainee, Golf (Payment Services Client) EXPERIENCES / Responsible for planning and executing event and experiential marketi...
  • 2 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Payment Recovery Specialist jobs found in Greenwich, CT area

F
Customer Experience Recovery Agent
  • FanDuel Inc.
  • Jersey City, NJ
  • **Customer Experience Recovery Agent** at FanDuel Jersey City, New Jersey **ABOUT FANDUEL GROUP** FanDuel Group is a wor...
  • 3/28/2024 12:00:00 AM

F
Seasonal Team Member
  • Familyfarmandhome
  • Harrison, NY
  • **Seasonal Team Member** 10501 New Haven Rd, Harrison, OH 45030, USA Req #5180 Tuesday, February 1, 2022 We are proud to...
  • 3/28/2024 12:00:00 AM

S
Sr. Reinsurance Business Analyst / Support
  • Saransh Inc
  • New York, NY
  • Role: Sr. Reinsurance Business Analyst / Support Location: NYC, NY (Day 1 Onsite) Contract Description: Support the setu...
  • 3/25/2024 12:00:00 AM

K
Asset Recovery Specialist
  • Kapitus
  • New York, NY
  • Job Description Job Description The Asset Recovery Specialist works predominantly with Kapitus Deputy General Counsel, t...
  • 3/24/2024 12:00:00 AM

L
Organ Procurement Specialist
  • LiveOnNY
  • Long Island City, NY
  • Overview: At LiveOnNY we save lives, provide comfort, and strengthen legacies through organ, eye and tissue donation for...
  • 3/24/2024 12:00:00 AM

I
Peer Specialist-CS531501
  • ICL
  • New York, NY
  • NOTE: All applicants must comply withICL"s vaccination policy. Individuals selected for employment cannot begin working ...
  • 3/24/2024 12:00:00 AM

R
Sorter
  • Republic Services, Inc.
  • Beacon, NY
  • The Sorter is responsible for safely and efficiently processing incoming recyclable materials so that outbound commoditi...
  • 3/24/2024 12:00:00 AM

A
Accountant II
  • AmTrust Financial Services, Inc.
  • Jersey City, NJ
  • Overview: AmTrust Financial Services, Inc. (the Company) is a global property and casualty insurance holding company tha...
  • 3/24/2024 12:00:00 AM

Greenwich /ˈɡrɛnɪtʃ/ is a town in Fairfield County, Connecticut, United States. As of the 2010 census, the town had a total population of 61,171. It is the 10th largest municipality in Connecticut, and the largest that functions as a town (the remaining largest municipalities in the state function as cities). The largest town on Connecticut's Gold Coast, Greenwich is home to many hedge funds and other financial service firms. Greenwich is the southernmost and westernmost municipality in Connecticut as well as in the six-state region of New England. It is roughly 40 to 50 minutes by train from...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Payment Recovery Specialist jobs
$55,973 to $73,652
Greenwich, Connecticut area prices
were up 1.7% from a year ago