The specialist reviews and identifies overpayments for self-pay and insurance credit balances, processing refunds while ensuring compliance with hospital policies. Duties include utilizing software to resolve credit balances, documenting all actions in account history, and assisting customers with reconciliation questions.

This role involves performing interactive interviews and reviewing applications for public assistance programs to determine applicant and recipient eligibility based on factors like income and household composition. Responsibilities also include processing applications through automated systems, calculating benefits, and interacting with clients regarding program rules and requirements.

This role involves leading a team of claims specialists to oversee and manage the pre-litigation and litigation phases of claims, focusing on timely recoveries and effective resolution. The supervisor will evaluate complex claims, approve settlements within authority, and collaborate closely with internal and external legal professionals to drive favorable outcomes.

The specialist will review documentation to make accurate and timely eligibility determinations for initial claims and recertifications within the Long-Term Care team. This involves communicating with internal teams and making outreach calls to gather necessary information while documenting all findings.