Claims Recovery Specialist – Join Our Mission at Molina healthcare
Are you detail-oriented and passionate about ensuring accuracy in healthcare billing? Molina Healthcare is seeking a dedicated Claims Recovery specialist to join our team and contribute to our mission of providing quality healthcare to those receiving government assistance. as a vital member of our finance department, you will play a key role in recovering outstanding overpayments from health plans and vendors.
What You’ll Do:
In this role, you will be responsible for the full lifecycle of overpayment recovery. This includes preparing detailed writen notifications to providers, complete with supporting documentation like explanations of benefits, claims, and attachments. You’ll maintain and reconcile critical departmental reports tracking collected payments, past-due amounts, uncollectible claims, and automated payment recoveries.
Your analytical skills will be put to use researching claims payments – from simple to complex – utilizing resources like DSHS and Medicare billing guidelines, Molina’s internal claims processing policies, and other relevant tools to validate overpayments. You’ll perform essential validation steps before offsetting payments, including verifying eligibility, coordination of benefits (COB), secondary payer details (SOC), and DRG assignments.
You will accurately enter and update recovery information in our recovery applications and claim systems for multiple states, crafting overpayment notification letters and processing refunds or auto-debits to meet production and quality standards. Adherence to departmental Standard Operating Procedures is crucial, encompassing claim processing (reversals and adjustments), claim recovery (refund requests, checks, reversals), and detailed recovery documentation.
you’ll respond to provider inquiries regarding recovery requests and remittances, and collaborate with our Finance team to ensure accurate and timely posting of provider and vendor refund checks and manual requests.
what We’re Looking For:
Required Experience & Skills:
* 1-3 years of experience in claims adjudication, as a Claims examiner II, or a related field.
* A minimum of 1 year of experience providing excellent customer service.
* At least 1 year of experience working within a healthcare insurance surroundings, specifically with Medicaid or managed Care programs.
* Strong written and verbal communication skills.
* Proficiency in Microsoft Office Suite, including Word and Excel.
Education:
* A high school diploma or equivalent is required.
Bonus Points:
* An Associate’s Degree or equivalent combination of education and experience is preferred.
* Prior experience in claims recovery is highly desirable.
What We Offer:
Molina Healthcare offers a competitive benefits and compensation package,and a chance to be part of a highly engaged workforce dedicated to making a difference in the lives of others.
Pay Range: $21.16 – $34.88 / HOURLY (Actual compensation may vary based on geographic location, experience, education, and skill level.)
To Apply:
Current Molina employees should apply through the intranet job listing.
Molina Healthcare is an Equal Prospect Employer (EOE) M/F/D/V.
Posting Date: 10/28/2025
