Claims Overpayment Specialist

Overview

Are you looking for a career that offers both purpose and the opportunity for growth? Parkland Community Health Plan (PCHP) is a proud member of the Parkland Health family. PCHP is a Medicaid Managed Care Organization servicing Texas Medicaid and CHIP in the Dallas Service Area. PCHP works to fulfill our mission by empowering members to live healthier lives. By joining PCHP, you become part of a team focused on innovation, person-centered care, and fostering stronger communities. As we continue to expand our services, we offer opportunities for you to grow in your career while making a meaningful impact. Join us and work alongside a talented team where healthcare is more than just a job—it's a passion to serve and improve lives every day.

Primary Purpose : The Claims Overpayment Specialist is responsible for reviewing, investigating, and resolving healthcare claim overpayments. This role ensures compliance with federal and state regulations while minimizing financial discrepancies.

Minimum Specifications

Education

• High school diploma or equivalent required.

Experience

Skills or Special Abilities

Responsibilities

Operations :

Data Analysis and Documentation

Regulatory :

Quality :

Professional Accountability

Job Accountabilities

Equal Employment Opportunity — Parkland Community Health Plan prohibits discrimination based on age (40 or over), race, color, religion, sex (including pregnancy), sexual orientation, gender identity, gender expression, genetic information, disability, national origin, marital status, political belief, or veteran status.

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