Senior Fraud Analyst handling complex products and escalated customer situations at Bank of America. Responsible for investigating fraudulent activity and ensuring compliance with industry regulations.
About the role
- Overpayment Recovery Analyst responsible for tracking and recovering overpayments within Stop Loss department. Conducting reconciliations and addressing various claim-related projects.
Responsibilities
- Track, calculate and pursue overpayments identified within Stop Loss department
- Research files and understand claims, type of overpayment, overpayment resolution options
- Follow up on overpayment requests with Administrator, Claim Analyst, Broker, both internal and external customers
- Provide monthly current recovery reports (analysis, trending, actions, status)
- Receive escheatment report, investigate customer data and provide data to banking for potential stop pay/re-issue of checks
Requirements
- 5+ years understanding of first dollar stop loss claims or medical claims
- Requires expert level understanding of the Stop Loss claims process or Medical Claims with respect to how overpayments are determined
- Prior experience in medical or Stop Loss claim adjudication
- Proficient in Excel with advanced skills, including complex formula construction, pivot table manipulation, Vlookup, queries creation
- Adept knowledge in navigating and utilizing SharePoint features at an intermediate level, including document management, tracker creation, and basic site administration
- Strong understanding of business and relationship building with external customers
- Highly skilled verbal and written communication skills.
Benefits
- Generous vacation and sick time
- Market-leading paid family, parental and adoption leave
- Medical coverage
- Company paid life and AD&D insurance
- Disability programs
- Partially paid sabbatical program
- 401(k) employer match
- Stock purchase options
- Employer-funded retirement account
- Flexible, inclusive and collaborative work environment
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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