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Overpayment Recovery Spec
at Sedgwick CMS in California
Overpayment Recovery Specialist
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To recalculate disability and paid medical leave claim benefits; to ensure payment accuracy, recovery of overpayment benefits or payment of underpaid benefits.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Performs underpayment and overpayment calculations for long term disability (LTD) and short term disability (STD) claims including appropriate state/federal tax calculations.
Contacts claimants to explain repayment of overpaid benefits; negotiates repayment schedule as needed.
Refers cases to collection agency; coordinates collection arrangements for non-responding claimants.
Administers commissions payable to collection agency per negotiated contract.
Processes claim overpayment refunds.
Requests and issues checks/vouchers for underpaid claimants.
Maintains contact with internal and external callers and promotes a professional client relationship while answering overpayment inquiries.
Enters and updates overpayment record or data in claims management system.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
AS/AA degree or two (2) years of college strongly preferred. BS/BA degree preferred. College field-related courses preferred.
Experience
Two (2) years overpayment recovery experience and/or claims management training required. AS/AA degree may substitute for one (1) year of the required experience; BS/BA degree may substitute for two (2) years of the required experience.
Skills & Knowledge
Knowledge of disability claims processes and benefit calculations
Knowledge of the claims management system
Excellent oral and written communication skills
PC literate, including Microsoft Office products
Strong organizational skills
Excellent negotiation skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
REQUIREMENTS: Must have experience with Microsoft Excel.
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/16899065
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To recalculate disability and paid medical leave claim benefits; to ensure payment accuracy, recovery of overpayment benefits or payment of underpaid benefits.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Performs underpayment and overpayment calculations for long term disability (LTD) and short term disability (STD) claims including appropriate state/federal tax calculations.
Contacts claimants to explain repayment of overpaid benefits; negotiates repayment schedule as needed.
Refers cases to collection agency; coordinates collection arrangements for non-responding claimants.
Administers commissions payable to collection agency per negotiated contract.
Processes claim overpayment refunds.
Requests and issues checks/vouchers for underpaid claimants.
Maintains contact with internal and external callers and promotes a professional client relationship while answering overpayment inquiries.
Enters and updates overpayment record or data in claims management system.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
QUALIFICATIONS
Education & Licensing
AS/AA degree or two (2) years of college strongly preferred. BS/BA degree preferred. College field-related courses preferred.
Experience
Two (2) years overpayment recovery experience and/or claims management training required. AS/AA degree may substitute for one (1) year of the required experience; BS/BA degree may substitute for two (2) years of the required experience.
Skills & Knowledge
Knowledge of disability claims processes and benefit calculations
Knowledge of the claims management system
Excellent oral and written communication skills
PC literate, including Microsoft Office products
Strong organizational skills
Excellent negotiation skills
Excellent interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT
When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
Sedgwick CMS is an Equal Opportunity Employer
and a
Drug-Free Workplace
REQUIREMENTS: Must have experience with Microsoft Excel.
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/16899065
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Published on Aug 21, 2010
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Viewed: 496 times
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