Payment & Refund Control Specialist - 37167354

Payment & Refund Control SpecialistJob SummaryThe Payment & Refund Control Specialist is responsible for the daily validation of multiple claims payment cycles, including accurate, efficient, and timely end-to-end processing of claims refunds and stop payment requests. This role includes balancing and verifying payment data against adjudication controls and check registers, evaluating the impact of claim adjustment transactions on payments, assisting with problem resolution with information systems staff, and communicating outcomes to various operational areas.Responsibilities

• Validate multiple claims payment cycles on a daily basis.
• Ensure accurate, efficient, and timely processing of claims refunds and stop payment requests.
• Balance and verify daily and monthly adjudication control data against check registers.
• Evaluate the impact of claim adjustment transactions on payments.
• Collaborate with information systems staff to resolve payment-related issues.
• Communicate payment and refund findings and status updates to operational teams.
• Maintain accurate records and documentation related to payment and refund activities.
• Protect the confidentiality of sensitive financial and member information.

Requirements

• Minimum of one year of recent bookkeeping or accounts receivable experience.
• Experience with Microsoft Excel.
• Claims processing or claims adjustment experience preferred.
• Proficiency with Microsoft Office applications, including Excel and Word.
• Proficiency with computer applications such as spreadsheets, word processing, and databases.
• Ability to work independently and as part of a team.

Summary Qualification

• Background in bookkeeping or accounts receivable.
• Experience supporting financial or claims-related processes.
• Demonstrated ability to manage multiple tasks with strong attention to detail.
• Proven ability to analyze information and exercise sound professional judgment.
• Strong written and verbal communication skills.

Skill

• Accounts receivable
• Multitasking
• Logical thinking
• Mathematics
• Problem solving
• Customer service
• Oral and written communication
• Interpersonal communication
• Information analysis
• Professional judgment
• Organization and detail orientation
• Time management
• Maintaining confidentiality
• Self-motivation and initiative
• Microsoft Office (Excel and Word)
• Use of spreadsheets, word processing, and database applications
• Ability to work independently and collaboratively in a team

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.