NGS Refund Investigator Sr

Company Name:
UniCare Life & Health Insurance Company
Job Description
An independent subsidiary of WellPoint, Inc, National Government Services (NGS) is one of the largest Medicare contractors in the country, serving nearly 200,000 providers and suppliers and over 20 million customers with Medicare in 20 states and five U.S. territories.
NGS Refund Investigator Sr. 86348
Preferred Location: S. Portland, ME (Rate of Pay $16.58)
Alternate Locations & Rate of Pay:
Washington DC - $19.20
Bethesda MD - $19.20
Baltimore MD - $18.33
Indianapolis IN - $17.46
Syracuse NY - $17.46
Harrisburg PA - $17.46
Richmond VA - $17.46
Shelbyville KY - $16.58
Denison TX - $16.58
Responsible for pursuing claims overpayments or reimbursements from other parties who may be liable for payment of claims. This level handles more complex issues, such as auditing and adjusting claims, COB, Medicare, Workers Compensation or subrogation .
Primary duties may include, but are not limited to:
Determines reason for overpayment or other party liability.
Calculates amount of overpayment.
Issues refund request letters or lien notices.
Responds to rebuttals and corresponds with involved parties.
Adjusts claims as required based on refund.
Successful track record for meeting tight deadlines.
Ability to work under limited supervision.
Requires high school diploma or equivalent and 4 years related experience in operations. Must have knowledge of relevant claims systems and related software and good PC skills. Requires strong problem-solving and oral and written communication skills.
_WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at_ _. EOE. M/F/Disability/Veteran.___
Job Qualifications
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.