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CTG Claims Recovery Collector in Irving, Texas

Claims Recovery Collector

Irving, Texas, United States


Information Technology

Jun 03, 2022Post Date

22201596Requisition #

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Our client in Irving, TX is looking for a Claims Recovery Collector for a contract role.

Job Title: Claims Recovery Collector

Job Location: Irving, TX, Contractor will be remote and working from home until the Irving office opens. The job will then move over to in office.

Job Type: Hourly Consultant

Pay: $18/hr, sorry no vacation or holiday pay

Hours: 8 am to 5pm, M-F

Skills would be: problem solving, written and verbal communication, team work and collaboration, active listening, adaptability, decision-making, customer service, organization, Microsoft Office (especially WORD, EXCEL and OUTLOOK), self-motivation, attention to detail, time management, SQL (preferred, but not required) and phone etiquette.

We are seeking a talented individual for a Claims Recovery Collector I who is responsible for recovering payments from commercial insurance carriers who should have paid primary to the Medicaid agency.

Essential Responsibilities:

  • Confer with Physicians/Providers by telephone, fax and email inquiries regarding outstanding overpayment recovery

  • Communicate with claims adjudicators for commercial carriers by telephone, fax and email to determine claim status and create claim-level appeals.

  • Leverage RCM Knowledge to assess denials, pursue appeals or close claims when appropriate.

  • Utilize and update client systems with proper notation of provider/carrier commentary, actions and appeal/denial information.

  • Responsible for initiating inquiries to other parties as needed to address claim adjudication issues or resolving inquiries associated with claims adjudication

  • Mail/fax/email letters to Physicians/Providers regarding payment of outstanding claims.

  • Contact providers to obtain additional information and/or documentation to resolve unpaid claims.

  • Pursue each outstanding account to reach maximum reimbursement by working with subject matter experts to resolve challenging claims.

  • Develop recovery strategies with each claim adjudicator, and/ or physicians/providers associated with the claim billing.

  • Assists with high priority special projects.

  • Confer with carriers by telephone or use carrier portals, or other web sites to determine member eligibility and claim status.

  • Assess denials, pursue appeals or close claims when appropriate.

  • Update case management system with proper noting of actions and appeal/denial information.

  • Respond to carrier telephone, fax and e-mail inquiries regarding outstanding claims.

  • Work with document imaging system for archival purposes.

  • Ensure that payers adhere to laws regarding timely filing of claims.

  • May have some training responsibilities limited to projects and specific tasks

Knowledge, Skills and Abilities:

  • Strong understanding of third-party billing and/or claims processing.

  • Ability to use critical thinking skills.

  • Possess good customer service skills.

  • Ability to adapt to change.

  • Ability to manage time effectively and multi-task.

  • Ability to prioritize work.

  • Ability to perform basic calculations.

  • Ability to work proficiently with Microsoft Windows, Word and have basic knowledge of Excel.

  • Average manual dexterity in use of a PC, phone, sorting, filing and other office machines.

  • Ability to be detail oriented.

  • Ability to learn and follow HIPAA privacy and Security rules.

  • Ability to work independently to meet predefined production and quality standards.

  • Ability to perform well in a team environment to achieve business goals.

Minimum Education:

High School Diploma or GED required, Associates degree preferred- Associates degree preferred with concentration in healthcare, medical billing or coding field

Minimum Related Work Experience:

  • This person must have pharmacy claims experience.

  • Two years of claims-related experience or provider billing/coding experience, which included significant use and application of CPT/ICD codes and standard health industry claim billing forms.

  • Must be able to demonstrate knowledge of medical terminology, coding, billing and claims processing obtained through work experience and/or completion of relevant claims, coding, or billing coursework.

  • Preferred experience handling and interpreting medical records, EOB’s, and standard health industry claim billing forms

Additional info.:

  • No third party resumes will be accepted

  • CTG will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

  • Drug testing and/or other employment-related inquiries may be conducted

  • All interested individuals MUST be able to work on a W2 Tax basis (no C2C or third party vendors).

  • CTG is an E-Verify Company

CTG is a leading provider of digital transformation solutions and services that accelerate clients' project momentum and achievement of their desired IT and business outcomes. Our vision is to be an indispensable partner to our clients and the preferred career destination for digital and technology experts. CTG has operations in North America, South America, Western Europe, and India. For more information, visit www.ctg.com.

Our culture is a direct result of the people who work at CTG, the values we hold, and the actions we take. In other words, our people are the culture. It's a living, breathing thing that is renewed every day through the ways we engage with each other, our clients, and our communities. Part of our mission is to cultivate a workplace that attracts and develops the best people, reflected by our recognition as a Great Place to Work-certified company across many of our global operations.

CTG will consider for employment all qualified applicants including those with criminal histories in a manner consistent with the requirements of all applicable local, state, and federal laws.

CTG is an Equal Opportunity and Affirmative Action Employer. CTG will assure equal opportunity and consideration to all applicants and employees in recruitment, selection, placement, training, benefits, compensation, promotion, transfer, and release of individuals without regard to race, creed, religion, color, national origin, sex, sexual orientation, gender identity and gender expression, age, disability, marital or veteran status, citizenship status, or any other discriminatory factors as required by law. Our Affirmative Action program serves to promote occupational equality and diversity through good faith efforts. CTG is fully committed to promoting employment opportunities for members of protected classes.

Additional Information

  • Job Function: Customer Support

  • Education Level: High School Diploma/GED (±11 years)

  • Work Remote: Yes

  • Travel: No