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Recovery Specialist, Medical Recovery Services

4 months ago

Saint Louis, United States Intellivo Full time
Job DescriptionJob DescriptionSalary: $25.00+ per hour


Recovery Specialist, Medical Recovery Services

 

Who is Intellivo?  

 

Powered by IntellivoIQ technology, we provide solutions to health providers and billers and for health plans and administrators by identifying previously undetected complex third-party liability (TPL) claims and increase the number of recovery opportunities resulting in higher reimbursements from TPL sources.   

 

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. And a team united by solving some of the most complex challenges on the financial side of healthcare.  

 

We are Intellivators – forward-thinking pioneers building the technologies that Fortune 500 employers, health plans, TPAs, providers, and billing organizations rely on to ensure responsible claim payments. Fueled by our experience and innovative startup mentality, we’re growing fast.  

 

Role Summary

 

As the Recovery Specialist, you will be responsible for investigating and resolving Worker’s Compensation, Motor Vehicle, and other Third-Party Liability claims for our healthcare provider and revenue cycle services clients. This includes making telephone calls to members, providers, and insurance companies to gather coordination of benefits and claims status data, researching claims on carrier portals, and/or obtaining and submitting necessary follow-up information (such as Medical Records) in order to resolve unpaid claims. You will be key in investigating and pursuing recoveries and payables while ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance.

 

Location 

 

This role is an on-site position in St. Louis, MO. 

 

Responsibilities 

 

  • Complete case/file set up on MVA/TPL/workers' compensation cases
  • Obtain all available data relevant to resolving claims on identified cases/events
  • Work with payers, providers, patients, attorneys, and other involved stakeholders to review case information and identify issues preventing claim resolution
  • Negotiate recovery amounts with applicable stakeholders (e.g., attorneys, other insurance carriers, members, providers) when necessary to resolve claims
  • Respond to correspondence requests and/or incoming phone calls related to open cases/claims
  • Manage, document, and prioritize case load - individual and department (e.g., TAT, schedule/workflow priority adherence)
  • Adhere to performance expectations related to productivity (daily events worked) and quality standards
  • Document outcomes of claims investigations in system of record
  • Develop and maintain relationships with applicable external stakeholders (e.g., providers, carriers, other relevant third parties)
  • Identify and report opportunities to improve processes, procedures, systems, and/or organizational structures (e.g., to drive improved quality/ efficiency, strengthen stakeholder relationships)
  • Demonstrate understanding of applicable federal, state, and local compliance regulations (e.g., DOI, DOL, Healthcare Reform/PPACA, CMS)

 

Qualifications 

  • BS/BA and 1-3 years of experience OR High School Diploma and 7+ years of experience
  • 1-3 years of experience in Revenue Cycle, Call Center Operations, and/or Office Admin.
  • Strong working knowledge of MS Office & MS Outlook
  • Driven and outgoing personality
  • Excellent communicate skills (written & verbal)
  • Well organized, detail oriented and flexible


Why work for Intellivo? 

 

  • Amazing Team Members – Intellivators
  • Medical Insurance
  • Dental & Vision Insurance
  • Industry leading health & wellness benefits
  • 401(K) retirement plan
  • Generous Paid Time Off
  • And More

 

 

*Benefit Recovery Group has been renamed Intellivo.