1 operations assistant jobs found in Washington

CAQH Position Summary This role supports a highly specialized Medicare Secondary Payer (MSP) recovery function focused on identifying and resolving incorrect CMS/Medicare payment cases. This role performs detailed, manual case review to validate coverage responsibility, identify overpayments, and drive recovery efforts with impacted plans. Due to CMS data access and extraction limitations, the work is highly analytical and manual in nature, requiring strong judgment, documentation rigor, and deep familiarity with benefits coordination and claims recovery processes. Specific Responsibilities Medicare Secondary Payer (MSP) & Claims Recovery Identify cases where Medicare was incorrectly designated as the primary payer. Perform detailed, manual review of member eligibility, coverage timelines, and payment responsibility to validate recovery opportunities. Support recovery of Medicare overpayments by coordinating accurate case documentation and...