Healthcare Billing Recovery Case Specialist I (SCA)

Handle Medicare Secondary Payer (MSP) recovery by reviewing delinquent provider accounts and verifying payment liability for claims potentially paid in error. Build case files using medical billing documentation, forms UB04 and CMS 1500, and Coordination of Benefits/Third Party Liability (COB/TPL). Interpret Explanation of Benefits (EOB), respond to defenses, initiate correspondence, update systems, and ensure on-time, policy-compliant processing while maintaining HIPAA compliance and meeting performance metrics.