Claim Review Specialist

24 hours ago


Memphis, United States Intellivo Full time

Claim Review Specialist

Who is Intellivo?

Powered by IntellivoIQ technology, we provide solutions to health providers, billers, health plans, and payers by locating previously undetected auto and workers' compensation payment sources to increase revenue for our healthcare clients.

Imagine a place where your talent is treasured, and excellence is rewarded. Now imagine a collaborative culture where every voice is valued. Fueled by over 25 years of experience and our innovative mentality, we continue to grow fast.

Role Summary

As a Claim Review Specialist, you will be responsible for investigating and identifying instances where bills are paid by both the health insurance and liability insurance then seeking reimbursement from the medical providers that were overpaid.

Location

This role is an on-site position at 6075 Poplar Ave., Memphis, TN 38119

Responsibilities

  • Review payout ledger from first-party insurance carriers or workers' compensation carriers to audit claims paid on behalf of the member to identify possible overpayments
  • Investigate and confirm overpayments made to providers
  • Seek refund(s) from medical provider(s) who were overpaid by the health plan's payment
  • Identify possible recoveries already received by a client and verify the reason for the reimbursement
  • Coordinate with all other departments within Intellivo when necessary
  • Contact Worker's Compensation Adjuster to verify claim eligibility
Qualifications

Our backgrounds are varied at Intellivo. If these statements sound like you, you might be a good fit for this role:
  • Minimum 2 years' experience in medical billing, insurance recovery, or Worker's Compensation
  • Analytical and detailed in thought and action
  • Excellent knowledge of claims processing and coordination of benefits
  • Excellent oral, written and interpersonal skills, including telephone etiquette
  • Demonstrated ability to work independently and to collaborate with a team
  • Ability to multi-task and prioritize work
  • Proficiency in Microsoft applications, including Word and Excel
  • High school diploma or equivalent
  • Some college preferred
Why work for Intellivo?
  • Amazing Team Members - Intellivators
  • Base compensation plus bonus potential
  • 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.

  • Memphis, United States First Horizon National Corporation Full time

    Location: On site at Knoxville, TN., Memphis, TN., or New Orleans, LA.At First Horizon Bank Operations, we are on a mission to deliver a seamless customer experience. We are passionate about doing things right and doing the right things. We collaborate with each other and with our internal business partners to delight our customers. We believe in creating an...


  • Memphis, United States First Horizon National Corporation Full time

    Location: On site at location listed in job posting.At First Horizon Bank Operations, we are on a mission to deliver a seamless customer experience. We are passionate about doing things right and doing the right things. We collaborate with each other and with our internal business partners to delight our customers. We believe in creating an environment where...


  • Memphis, United States Baptist Memorial Healthcare Corporation Full time

    Summary Responsible for daily customer inquiries from internal and external customers to completion. Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing....


  • Memphis, United States Baptist Memorial Full time

    Summary Responsible for daily customer inquiries from internal and external customers to completion. Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing....


  • Memphis, United States Advertising Checking Bureau Full time

    The CSR is responsible for providing outstanding customer service to clients, customers (internal and external) and third parties via telephone, email, and fax. The CSR ensures compliance with client's program specifications and ACB policies and procedures. Specific CSR duties may be dependent on the client(s) they support. CSR must manage communications...


  • Memphis, United States Silver Tree Residential, LLC Full time

    Silver Tree Residential, LLC (STR) is one of the fastest growing property management companies in the industry. We are a privately-owned Memphis-based multifamily real estate company that owns and operates 100 properties in 26 states totaling nearly 13,500 units. James Carmichael formed STR in 2009 to achieve the quality standards that he strived for in each...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 4FF4C3AB797F40628EE1D0317CDAC89F [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 22AC213B54244264B96BBD676C03845C [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: C102D7E54A6E4F9E8E6F56B0CBF27CAF [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 66887EEEB70F48C797BBC4F4940D10E6 [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: C102D7E54A6E4F9E8E6F56B0CBF27CAF [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: F295AE3D74644D368242426847A44EC7 [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 4FF4C3AB797F40628EE1D0317CDAC89F [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 66887EEEB70F48C797BBC4F4940D10E6 [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, United States Home Depot Full time

    Home Depot - JobID: 22AC213B54244264B96BBD676C03845C [Loss Prevention / Security] As an Asset Protection Specialist at Home Depot, you'll: Prevent financial loss caused by theft and fraud; Support safety and environmental program compliance in your assigned store/multiple stores; Identify incidents of theft and fraud, review CCTV and exception reports,...


  • Memphis, Tennessee, United States Takeda Full time

    About the Role:As a Medical Support Specialist at BioLife, you will play a critical role in ensuring the safety and well-being of donors. Your primary responsibility will be to determine donor eligibility for plasma donation, which includes conducting medical history interviews, reviewing laboratory test results, and managing donor adverse events. You will...


  • Memphis, United States TAJ Technologies Inc Full time

    MANAGER'S NOTES: • Bachelor's degree required; major in computer science field preferred. • Six (6) years of related experience or an equivalent combination of education and experience is required. Experience in multi-line claims management or case management processes and system requirements is strongly preferred. • Strong knowledge of...


  • West Memphis, United States GPM Investments, LLC Full time

    Perform Fleet and Safety inspections on Drivers and Transportation equipment. Review telematics management system for DOT Compliance. Facilitate communication between drivers and dispatch on needed repairs and/or maintenance to fleet vehicles. Review Safety Specialist, Transportation, Transport, Specialist, Manufacturing, Safety


  • Memphis, Tennessee, United States HSD Campus Full time

    Cyberveiligheid SpecialistWe zoeken een Cyberveiligheid Specialist voor onze organisatie. Als Cyberveiligheid Specialist zul je ons helpen om de beste cyberveiligheid oplossingen te ontwikkelen en uit te voeren.Functieomschrijving:Het belangrijkste doel van deze positie is het identificeren en analyseren van cybersecurity-risico's en -zwaktes in onze...


  • Memphis, Tennessee, United States THORNDALE PARTNERS Full time

    Thorndale Partners, LLC is a trusted talent acquisition partner dedicated to providing a premium experience for both job seekers and hiring managers.Compensation: The estimated salary for this role is $85,000 - $110,000 per year, depending on qualifications and experience.About the RoleThis Senior Financial Reporting Specialist position provides key support...