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Recovery Specialist Associate ...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
Miami, FL
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS3507

Recovery Specialist Associate - Miami, FL - PS3507

About the Job

Description

Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

Recovery Specialist Associate - Miami, FL - PS3507

The Recovery Specialist Associate is responsible for identifying, tracking, and reconciling overpayments made to providers and ensuring that recovery is made and reported under general supervision. Performs all authorized duties in the processing of overpayments allocated to the assigned market consistent with all applicable company and departmental policies. Primary duties may include, but are not limited to:

  • Processes daily provider refund checks and adjustment requests from overpayment projects.
  • Interprets policy provisions to accurately process overpayment adjustments in accordance with department policies.
  • Responds to calls, letters, and emails from policyholders, agents, vendors and/or providers.
  • Maintains working knowledge of all company products and services pertaining to business segment.
  • Works with health plans regarding overpayment Provider disputes.
  • Communicates with Providers regarding overpayment disputes on occasion.
  • Adheres to company and department policies and procedures as well as HIPAA regulations.
  • Performs other duties as requested or assigned.

Qualifications

Requires:

  • 2 years of claims or data entry experience; or any combination of education and experience, which would provide an equivalent background.
  • High School diploma or GED.
  • Medical claims processing experience preferred.
  • Experience working with Excel
  • Experience working with collections a plus
  • Must have knowledge of relevant claims systems and related software and good PC skills.
  • Requires strong problem-solving and oral and written communication skills.

  • Strong attention to detail.

  • Previous experience in healthcare or manage care preferred.

  • Call Center experience a plus.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.


 

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