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Recovery Specialist

2 months ago

Salt Lake City, United States TEKsystems Full time

A WELL KNOWN HEALTH PLAN COMPANY WITHIN MURRAY, UT IS LOOKING TO BRING ON A RECOVERY SPECIALIST TO JOIN THEIR PREMIUM BILLING TEAM.

If you feel you have the relevant experience, please apply and a recruiter will reach out to discuss details and outline next steps

*Pay:* $20/hr

*Schedule:* Mon-Fri 8:30-5 or 8-4:30

One-Step Onsite Interview with Hiring Manager & Team Lead

*Start Date:* 8/5

Interviewing onsite Week of July 8th

*6-Month Contract to Start* - Can be extended or given the opportunity to apply internally to become a Full-Time Employee

*Description:*

Provides accurate collection, reporting, and follow-up on all refund and over payment checks from providers, insured members, and third parties. Accurate correction of claims history and medical expense accounts.

1. Researches and accurately applies checks, credit cards, and other sources of payment for pharmacy and medical claims.

2. Accurately evaluates the correct adjustments for medical, historical, regular claims adjustments, and pharmacy claims adjustments. Processes basic external subrogation adjustments.

3. Reconciles all deposits or payment batches to verify that cash received balances and needed claims are adjusted. Familiarity with all tracking databases and posts cash to complete refund requests.

4. Accurately indexes all scanned deposits to affected claims. Maintains the department's standard of accuracy on deposit work as determined by the Auditing team in weekly audits.

5. Accurately requests refunds within correct time frames and makes necessary updates for cash received, cancellations, and other maintenance adjustments.

6. Makes outbound telephone calls to providers and members to collect on monies due that are not able to be auto recovered.

7. Regularly and timely reports accounts that appear to be uncollectible to the supervisor for further collection action.

8. Responsible for follow up on all claims adjudicated that the system generates recovery letters for.

9. Appropriately answers all telephone calls from providers, members, and other staff or departments. Understands the basic auto recovery process and is able to adequately explain and track the process to providers, members, and other staff. Maintains telephone availability percentages and telephone logged in time expectations.

10. Provides timely responses to correspondence and phone mail requests that are addressed to the team.

11. Processes monthly medical and pharmacy retro termination reports. Maintains minimum expected production level. Completes daily tracking sheet and spreadsheet to verify production levels.

12. Prepares and delivers documentation needed for Accounts Payable to finalize journal entries for deposits and other payment batches.

*Additional Skills & Qualifications:*

Effective interpersonal, verbal, and written communication skills.

Strong organizational skills and attention to detail

Ability to de-escalate hard conversations

*Experience Level:*

Entry-Intermediate

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.