Medicare Examiner II (Hybrid)

At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better.

Role Overview:

Could you be our next Medicare Examiner II? Globe Life is looking for a Medicare Examiner II to join the team!

This role is responsible for the timely and accurate processing of claim refund checks received in our office from providers, and in rare cases insureds. This position will coordinate with General Accounting for void/stop payment requests as well as respond to inquiries for check information.

This is a hybrid position located in McKinney, Texas (WFH Monday & Friday, In Office Tuesday-Thursday).

What You Will Do:

• Review correspondence and Explanation of Benefits (EOBs) to verify reason for returned check (i.e. refund or reissue).
• Process refunds due to overpayments and ensure monies are credited to the appropriate account/company.
• Request additional information from provider required to accurately process refunds, as needed.
• Route checks needing to be reissued to appropriate examiner for processing.
• Identify non-claim-related checks and route to the appropriate business units (i.e. Unclaimed Property, Premium Accounting, Agency Services, etc.).
• Identify refund checks that are over original claim amount and process check requests to issue overage amount back to provider.
• Coordinate with General Accounting for verification of check status on void/stop payment requests.
• Respond to incoming inquires received through various channels (i.e. Customer Service, faxes, email, etc.).
• Maintain and ensure security of file cabinet with refund checks and other correspondence.
• Review daily Onbase reports to perform reconciliation of previous days’ refunds.
• Review monthly Optum Recovery invoice to ensure proper credits/debits have been applied prior to processing invoice payment.
• Concurrently access multiple databases, software programs, and/or online tools to perform required job functions.
• Meet and/or exceed established standards for productivity and quality, including 14 day turnaround and 2% error rate.
• Attend and actively participate in departmental meetings, trainings, and coaching sessions.
• Support and participate in all mandatory compliance training.
• Maintain patient privacy and confidentiality in accordance with HIPAA standards.
• Perform additional clerical and administrative support duties as assigned by management.

What You Can Bring:

• High School Diploma or equivalent required.
• Associate’s Degree preferred.
• 2 years’ experience in accounting or financial record keeping.
• Data Entry or Medicare Claims processing experience a plus.
• Ability to maintain confidentiality with sensitive customers and internal information.
• Ability to compile and review information to make sound decisions.
• Skilled in performing intermediate arithmetic calculations.
• Excellent typing skills.
• Proficiency in Microsoft Office Suite (i.e. Outlook, Excel, Word) and other basic computer programs.
• Strong organizational skills and detail-oriented approach to work.
• Excellent written and verbal communication skills.
• Ability to thrive in fast paced environment while working independently and with limited supervision.
• Positive team-oriented attitude with flexibility to adjust to changes as they arise.

Applicable To All Employees of Globe Life Family of Companies:

• Reliable and predictable attendance of your assigned shift.

• Ability to work full time and/or part time based on the position specifications.

How Globe Life Will Support You:

Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don’t just work, but thrive at Globe Life:

• Competitive compensation designed to reflect your expertise and contribution.

• Comprehensive health, dental, and vision insurance plans because your well-being is fundamental to your performance.

• Robust life insurance benefits and retirement plans, including company-matched 401k and pension plan.

• Paid holidays and time off to support a healthy work-life balance.

• Parental leave to help our employees welcome their new additions.

• Subsidized all-in-one subscriptions to support your fitness, mindfulness, nutrition, and sleep goals.

• Company-paid counseling for assistance with mental health, stress management, and work-life balance.

• Continued education reimbursement eligibility and company-paid FLMI and ICA courses to grow your career.

• Discounted Texas Rangers tickets for a proud visit to Globe Life Field.

Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters.